Defazio, Ernest
Defazio, Ernest is an individual health care provider with primary practice located at 181 Franklin Ave , Nutley NJ 07110-3820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Defazio, Ernest can be contacted via phone (973) 667-6660.Contact Information
Primary practice address
181 Franklin Ave
Nutley NJ 07110-3820
Phone: (973) 667-6660
Fax: (973) 667-2134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA03416900 | New Jersey |
Profile Details
| NPI number | 1477511707 |
|---|---|
| LBN Legal business name | Defazio, Ernest |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477511707 | NPPES |
| New Jersey | MEDICAID | 0829005 |
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