Difazio, Joseph

Difazio, Joseph is an sole proprietor health care provider with primary practice located at 107 Monmouth Rd Suite 101, West Long Branch NJ 07764-1000. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Difazio, Joseph can be contacted via phone (732) 542-0011.

Contact Information

Primary practice address
107 Monmouth Rd Suite 101 West Long Branch NJ 07764-1000
Phone: (732) 542-0011
Fax: (732) 542-9419
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X 22DI01294600 New Jersey
Dental Providers / Prosthodontics 1223P0700X 3161 New Jersey

Profile Details

NPI number 1235264227
LBN Legal business name Difazio, Joseph
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2007
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235264227 NPPES
New Jersey MEDICAID 1160430

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