Provider Demographics
NPI:1659376184
Name:DIFRESCO, VERONICA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:ANN
Last Name:DIFRESCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8120 WOODMONT AVE
Mailing Address - Street 2:STE 320
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2743
Mailing Address - Country:US
Mailing Address - Phone:301-656-4010
Mailing Address - Fax:301-654-2319
Practice Address - Street 1:1201 SEVEN LOCKS RD
Practice Address - Street 2:STE 111
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2957
Practice Address - Country:US
Practice Address - Phone:301-762-5020
Practice Address - Fax:301-294-7569
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0060401207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD416344300Medicaid
MDG90499Medicare UPIN
DC138460Medicare PIN