TIFFANY KELLY DISANZO

RALEIGH, NC
NPI1043917354
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: NC  0010-13523)
Additional Taxonomies363A00000X Physician Assistant
(Licence: NC  0010-13523)
Enumeration Date2023-02-08
Last Update Date2023-09-12
Business Address
TIFFANY KELLY DISANZO
3000 NEW BERN AVE
RALEIGH, NC 27610-1231
Phone number: 919-350-8000
Mailing Address
TIFFANY KELLY DISANZO
63 HAVISTOCK CT
CAMERON, NC 28326-6330
Phone number: