JESSICA DIFABIO (NPI# 1508315730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508315730 |
| Entity Type | Individual |
| Full Name | JESSICA DIFABIO |
| Credential | APRN |
| Practice Address |
1 Long Wharf Dr New Haven CT 06511-5991 |
| Practice Telephone | 2037814600 |
| Practice Fax Number | 2037814624 |
| Mailing Telephone | 2037814600 |
| Mailing Fax Number | 2037814624 |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2019-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
6664 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008039745 | 05 | |
| CT | SCHEFILITI MEDICAID # | 008068420 | 01 |
| CT | 004217099 | 05 | |
| CT | 008056168 | 05 | |
| CT | 008056033 | 05 |
| Street Address |
1 LONG WHARF DR |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-5991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174510440 | Jane Lawrence-riddell | Nurse Practitioner | 1 Long Wharf Dr, Suite 105, New Haven, CT 06511-5991 | 2005-10-03 |
| 1033726856 | Mekessia Richards-carby | Nurse Practitioner | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2020-09-25 |
| 1942843081 | Cassandra Marie Irizarry | Counselor | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2019-10-22 |
| 1003463159 | Ashley Antonucci | Nurse Practitioner | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2019-08-22 |
| 1720559438 | Yvonne Bolumole | Registered Nurse | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2018-12-07 |
| 1295206803 | Debbie A. Koonce | Licensed Practical Nurse | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2018-12-07 |
| 1659862274 | Nathan Lipkind | Social Worker | 1 Long Wharf Dr, New Haven, CT 06511 | 2018-05-21 |
| 1851893549 | Sammy Falcon | Counselor | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2018-03-08 |
| 1891217022 | Lisa Magistro | Nurse Practitioner | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2017-07-10 |
| 1972036622 | Julie A. Mcglynn | Genetic Counselor, MS | 1 Long Wharf Dr, 2nd Floor; Room 293, New Haven, CT 06511-5991 | 2017-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330571 | Allison Elizabeth Pratt | Occupational Therapist | 625 Whitney Ave, Apt 5, New Haeven, CT 06511 | 2020-09-11 |
| 1881213346 | Sarah Bleicher | Registered Nurse | Yale Health, 55 Lock St, New Haven, CT 06511 | 2020-04-14 |
| 1083268395 | Danielle Lee Mcpherson | Pharmacist | Yale New Haven Hospital 55 Park Street, New Haven, CT 06511 | 2019-07-25 |
| 1528533866 | Alexia Levin | Social Worker | 98/100 York St, New Haven, CT 06511 | 2018-10-12 |
| 1861970097 | Orthocare Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1450 Chapel St Ste Sg15, New Haven, CT 06511 | 2018-07-31 |
| 1609352418 | Susannah Frew | Social Worker | 2 Eld Street, Apt 6, New Haven, CT 06511 | 2018-07-15 |
| 1851881965 | Empowerment Counseling Services, LLC | Counselor | 427 Dixwell Ave, New Haven, CT 06511 | 2018-05-14 |
| 1487173951 | Karine Giasson-gariepy | Student in an Organized Health Care Education/Training Program | Yale University Department of Psychiatry, 300 George Street, Suite 901, New Haven, Ct 06511, New Haven, CT 06511 | 2017-09-15 |
| 1568980696 | Anna Reutenauer | Dentist | 123 York St Ste 4l, New Haven, CT 06511 | 2017-09-08 |
| 1083134753 | Darin Dolezal | Student in an Organized Health Care Education/Training Program | 200 South Frontage Road, Ep2 2nd Floor - 612, Dept of Pathology, New Haven, CT 06511 | 2017-06-23 |
| Find all providers in zip 06511 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437694726 | Samantha N Nesbeth | Nurse Practitioner | 428 Columbus Ave, Internal Medicine, New Haven, CT 06519 | 2016-12-22 |
| 1598219636 | Carol Anne Standish | Nurse Practitioner | 1 Long Wharf Dr Ste 500, New Haven, CT 06511-5593 | 2016-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161170 | Lisa B Stein | Nurse Practitioner | 861 Brooklawn Ave, Fairfield, CT 06825-1809 | 2020-10-15 |
| 1194322800 | Constantin Razvan Popescu | Nurse Practitioner | 46 Summer View Dr, Monroe, CT 06468-2001 | 2020-10-06 |
| 1538785902 | Lms Health LLC | Nurse Practitioner | 2001 W Main St Ste 244, Stamford, CT 06902-4544 | 2020-06-22 |
| 1760001010 | Mobile Care Partners of Connecticut Pllc | Nurse Practitioner | 44 Luzi Dr Apt 960, Bantam, CT 06750-1619 | 2020-04-15 |
| 1740811454 | Melissa Jennifer Mokel | Nurse Practitioner | 122 Cornerstone Dr, South Windsor, CT 06074-6303 | 2020-01-31 |
| 1861037533 | Olga Poznyur | Nurse Practitioner | 19 Woodland St Ste 21, Hartford, CT 06105-2372 | 2019-11-16 |
| 1356996904 | Virginia Tran | Nurse Practitioner | 39 Maple Tree Ave Unit 34, Stamford, CT 06906-2273 | 2019-08-09 |
| 1336705839 | Rose-ann Cashema Richards | Nurse Practitioner | 34 Heather Ln, Manchester, CT 06040-6903 | 2019-05-10 |
| 1144706631 | Chana Judith Hoagland | Nurse Practitioner | 276 Quarry Brook Drive, South Windsor, CT 06074 | 2018-07-17 |
| 1427549088 | Kelly Elizabeth Sullivan | Nurse Practitioner | 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 | 2018-05-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.