Individual provider · Type 1 NPI

Nilla Defazio, PA-C

Physician Assistant · Montclair, NJ

NPI number 1336100486 Active

Practice location

1 Bay Ave
Montclair, NJ 07042-4837

Call (973) 429-6695 Map

Mailing address

2828 Croasdaile Dr
Durham, NC 27705-2505

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X25MP00034900 (NJ)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1336100486

Nilla Defazio, PA-C's National Provider Identifier is 1336100486, issued on Mar 29, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Montclair, NJ. The record was last updated on Jul 13, 2026.