Jacqueline Lydia Difelice, PA-C

NPI #1316753254 in Marietta, Georgia

Provider Information

NPI Number: 1316753254
Entity Type: Individual
Name: Jacqueline Lydia Difelice, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 5, 2024
Last Updated: Dec 5, 2024

Practice Location

Address: 61 WHITCHER ST NE STE 1100
City: Marietta
State: Georgia
ZIP Code: 30060-1177
Phone: (770) 422-3290

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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