Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N002491-1 | NY |
NPI | 1346275351 |
---|---|
Provider Name | Roy R. Defrancis |
First Address | Cheektowaga, NY 14227-3530 |
Second Address | Cheektowaga, NY 14227-3530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T26031 | (02) | NY |