Provider Demographics
NPI:1376710319
Name:NEUFFER, DACIA DIANE
Entity Type:Individual
Prefix:MS
First Name:DACIA
Middle Name:DIANE
Last Name:NEUFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DACIA
Other - Middle Name:DIANE
Other - Last Name:NEUFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:20401 N 73RD ST STE 230
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4153
Mailing Address - Country:US
Mailing Address - Phone:480-556-0446
Mailing Address - Fax:623-209-7669
Practice Address - Street 1:20401 N 73RD ST STE 230
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4153
Practice Address - Country:US
Practice Address - Phone:480-556-0446
Practice Address - Fax:623-209-7669
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7139363A00000X
NY009795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty