Defazio, Lee Mcdonald

Defazio, Lee Mcdonald is an individual health care provider with primary practice located at 62 Industrial Park Rd , Lake Ariel PA 18436-5606. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Defazio, Lee Mcdonald can be contacted via phone (570) 689-7565.

Contact Information

Primary practice address
62 Industrial Park Rd Lake Ariel PA 18436-5606
Phone: (570) 689-7565
Fax: (570) 689-4803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X SP009466 Pennsylvania

Profile Details

NPI number 1346439981
LBN Legal business name Defazio, Lee Mcdonald
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2007
Last updated Mar 17th, 2018 - about 8 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 1346439981 NPPES
Pennsylvania MEDICAID 1025941780002
Pennsylvania MEDICAID 1025941780001
Pennsylvania MEDICAID 1025941780003
Pennsylvania MEDICAID 1025941780004

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