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Louis Thomas Difazio

Emergency Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as LOUIS DIFAZIO.

Based on the most recent information from CMS, provider Louis Thomas Difazio is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1376510032
Provider Type
Individual
Full Name
Difazio, Louis Thomas
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/2/2006
Last Updated
5/5/2015

Contact Information

Practice Location

435 South St, Morristown, NJ 07960-6422

(973) 971-7200

Unlisted Fax

Mailing Location

PO Box 23831, Newark, NJ 07189-0001

(973) 971-5595

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 25MA05768200 New Jersey

Louis Thomas Difazio

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Atlantic Advanced Urgent Care

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Sturm, David J

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