Provider Demographics
NPI:1699072157
Name:DEFRUSCIO, DARCY KAREN (NP)
Entity type:Individual
Prefix:MS
First Name:DARCY
Middle Name:KAREN
Last Name:DEFRUSCIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1752
Mailing Address - Country:US
Mailing Address - Phone:315-475-8401
Mailing Address - Fax:
Practice Address - Street 1:945 E GENESEE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1752
Practice Address - Country:US
Practice Address - Phone:315-475-8401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily