Defazio, Jennifer Marie

Defazio, Jennifer Marie is an individual health care provider with primary practice located at 517 Moye Blvd , Greenville NC 27834-2849. She recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as her primary health care specialty. Defazio, Jennifer Marie can be contacted via phone (252) 744-3109.

Contact Information

Primary practice address
517 Moye Blvd Greenville NC 27834-2849
Phone: (252) 744-3109
Fax: (252) 744-2096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 2009-01325 North Carolina
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 22380 West Virginia

Profile Details

NPI number 1508988742
LBN Legal business name Defazio, Jennifer Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2007
Last updated Feb 7th, 2024 - about 2 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 1508988742 NPPES
North Carolina Other 153RU BCBSNC
North Carolina MEDICAID 5912475 BCBSNC

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