Individual
CAROLYN DIFONZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
7350 PORTER RD, NIAGARA FALLS, NY 14304-5705
(716) 332-1644
(716) 299-0775
Mailing address
7350 PORTER RD, NIAGARA FALLS, NY 14304-5705
(716) 332-1644
(716) 299-0775
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F 334650 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027338407
UNIVERA/EXCELLUS
NY
01
—
000560981002
BLUE CROSS /BLUE SHIELD W
NY
01
—
9513035
IHA PROVIDER ID
NY
Enumeration date
07/14/2006
Last updated
07/18/2016
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