Individual
THERESA DIFABRIZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 TWIN SPRINGS RD, HALETHORPE, MD 21227-3553
(410) 737-5300
Mailing address
739 S LINWOOD AVE, BALTIMORE, MD 21224-3853
(760) 419-4413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
51688
CA
363AS0400X
Surgical Physician Assistant
Primary
C0006812
MD
Other
Enumeration date
10/22/2014
Last updated
06/01/2021
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