Most Relevant Information
Provider Data
| NPI Number: | 1003318056 |
| Provider Name: | JENNIFER MARIE DEFAZIO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/06/2018 |
| Last Updated: | 03/06/2018 |
Provider Practice Location
4200 5TH AVE
PITTSBURGH
PA
152600001
Practice Location Phone/Fax
| Phone: | 4126244141 |
| Fax: |
Provider Mailing Location
2968 BELROSE AVE
PITTSBURGH
PA
152162015
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |