Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1003249020 Individual Practitioner Female Practitioner

Jennifer Disla

Specialist • Corona, NY

Professional Overview & Biography Verified Profile Summary

Jennifer Disla is a registered healthcare professional specializing in Specialist in Corona, NY. Practice services are available at 11172 42ND AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11172 42nd Ave

Corona, NY 113682620

Telephone 7184580571

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Corona, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 57.0 Yrs
State Avg: 34.9 Yrs
Regional Practice Density
28 Specialists

Practicing in Corona, NY (23296 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License NY 1191109

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 13, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location August 13, 2013

Registered at 11172 42ND AVE, CORONA, NY 113682620 (Tel: 7184580571)

📍
Updated Business Mailing Address August 13, 2013

Registered at 111-72 42ND AVENUE, CORONA, MT 11368 (Tel: 7184580571)

👤
Provider Name / Credentials Updated August 13, 2013

Recorded as JENNIFER DISLA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 13, 2013

Specialist (License #1191109 in NY)

🟢
Initial NPI Registration & Enumeration August 13, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003249020
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 13, 2013
Last Update: August 13, 2013
Sole Proprietor: No

Mailing Address

111-72 42nd Avenue

Corona, MT 11368

Phone: 7184580571

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.