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Contact Information

MBWIDIFFU A DIBAL, NP-C
2600 GLASGOW AVE STE 104
NEWARK, DE19702-5703
 Phone: 302-770-0030
 Fax: 302-273-0031
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MBWIDIFFU A DIBAL · (Female)

NPI Number 1629473483
Status Active
Credentials NP-C (Nurse Practitioner - Certified)
Entity Individual
Enumeration date 10/22/2014
Last updated 05/08/2026 - About a month ago
Sole proprietor 1 Yes
Identifiers
  • DE License # LG-0000757
  • DE Medicaid 200141998
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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