Provider Demographics
NPI:1912009002
Name:DIFABIO, JOSEPH SAMUEL SR (RN, NP-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SAMUEL
Last Name:DIFABIO
Suffix:SR
Gender:M
Credentials:RN, NP-C
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Mailing Address - Street 1:B4 MURRAY HL
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1347
Mailing Address - Country:US
Mailing Address - Phone:315-430-8109
Mailing Address - Fax:
Practice Address - Street 1:17 LANSING ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1983
Practice Address - Country:US
Practice Address - Phone:315-255-7011
Practice Address - Fax:315-255-7281
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF-332439-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily