Provider Demographics
NPI:1003198961
Name:DEFRANCO, LYDIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:
Last Name:DEFRANCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2519
Mailing Address - Country:US
Mailing Address - Phone:732-462-5841
Mailing Address - Fax:732-462-7832
Practice Address - Street 1:425 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-462-5841
Practice Address - Fax:732-462-7832
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1855900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist