Doctor Name: | MS. PATRICIA A DIFFENDALE |
NPI Number: | 1043294135 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 119025 |
Business Practice Address: | 175 State Ave Monson Developmental Ctr Palmer, MA - 010691843 |
Business Phone Number: | 4132833411 |
Business Fax Number: | 4132831361 |
Mailing Address: | 4 West St, BELCHERTOWN |
State: | MA |
Postal Code: | 010079621 |
Phone Number: | 4132835545 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 119025 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |