Provider Demographics
NPI:1043568678
Name:LAFRANCA, PETER GABRIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:GABRIEL
Last Name:LAFRANCA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16334 91ST ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3724
Mailing Address - Country:US
Mailing Address - Phone:917-496-3056
Mailing Address - Fax:
Practice Address - Street 1:15814 CROSSBAY BLVD
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3136
Practice Address - Country:US
Practice Address - Phone:718-659-9500
Practice Address - Fax:718-659-9100
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist