Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 402648 | NY |
NPI | 1033777867 |
---|---|
Provider Name | Mr. Carl F De Franco II |
First Address | Buffalo, NY 14210-1358 |
Second Address | Niagara Falls, NY 14304-1550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2019 |
Last Update Date | 07/09/2020 |