Provider Demographics
NPI:1700667482
Name:DIFO, ALLYAH MARAINY
Entity Type:Individual
Prefix:
First Name:ALLYAH
Middle Name:MARAINY
Last Name:DIFO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-2713
Mailing Address - Country:US
Mailing Address - Phone:908-425-1549
Mailing Address - Fax:
Practice Address - Street 1:1350 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-2713
Practice Address - Country:US
Practice Address - Phone:908-425-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program