Active NPI
Carlee Difucci
- Physician Assistant
- Erie, PA
National Provider Identifier
1417366360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- TMA052931
- Practice address
- 2315 Myrtle St
Suite 290
Erie, PA 16502-4602 - Phone
- (814) 454-1142
- Fax
- (814) 454-1255
- NPI assigned
- Aug 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TMA052931 | PA | Primary |
Addresses
Primary practice location
2315 Myrtle St
Suite 290
Erie, PA 16502-4602
Mailing address
2315 Myrtle St
Suite 290
Erie, PA 16502-4602
Phone (814) 454-1142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TMA052931 | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1417366360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 MYRTLE ST",
"address_2": "SUITE 290",
"city": "ERIE",
"state": "PA",
"postal_code": "165024602",
"telephone_number": "814-454-1142",
"fax_number": "814-454-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 MYRTLE ST",
"address_2": "SUITE 290",
"city": "ERIE",
"state": "PA",
"postal_code": "165024602",
"telephone_number": "814-454-1142",
"fax_number": "814-454-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFUCCI",
"first_name": "CARLEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "TMA052931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.