Nilla Defazio, PA-C
Physician Assistant in Montclair, New Jersey
1336100486- Practice location
- 1 Bay Ave, Montclair, NJ 07042-4837
- Phone
- 973-429-6695
- Fax
- —
- Last updated
- July 13, 2026
Nilla Defazio is a Physician Assistant based in Montclair, NJ. Nilla Defazio practices in Montclair, NJ and has the professional credentials of PA-C. The NPI Number for Nilla Defazio is 1336100486 and holds a License No. 25MP00034900 (NJ). The current practice location address for Nilla Defazio is 1 Bay Ave, Montclair, NJ 07042-4837 and can be reached out via phone at 973-429-6695.
Provider Profile Details
- NPI Number
- 1336100486
- Provider Name
- Nilla Defazio
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1 Bay Ave, Montclair, NJ 07042-4837
- Phone Number
- 973-429-6695
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 29, 2006
- Last Update Date
- July 13, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Bay Ave
Montclair, NJ 07042-4837 - City
- Montclair
- State
- New Jersey
- Zip
- 07042-4837
- Phone Number
- 973-429-6695
Provider Business Mailing Address Details
- Address
- 2828 Croasdaile Dr
Durham, NC 27705-2505 - City
- Durham
- State
- NC
- Zip
- 27705-2505
- Phone Number
- 919-425-1564
License Information
- License Number
- 25MP00034900
- License State
- NJ
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Nilla Defazio, PA-C?
The NPI number of Nilla Defazio, PA-C is 1336100486. It was assigned on March 29, 2006 and is currently active in the NPPES registry.
What is the specialty of Nilla Defazio, PA-C?
Nilla Defazio, PA-C is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in NJ under license number 25MP00034900.
Where does Nilla Defazio, PA-C practice?
The practice location is 1 Bay Ave, Montclair, NJ 07042-4837. The office can be reached at 973-429-6695 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1336100486 directly on the NPPES registry website.