Provider Demographics
NPI:1114992351
Name:DEFRANCO, ALBERT B (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:B
Last Name:DEFRANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:497 BUSHKILL PLAZA LN
Mailing Address - Street 2:
Mailing Address - City:WIND GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18091-9665
Mailing Address - Country:US
Mailing Address - Phone:610-863-7020
Mailing Address - Fax:610-863-5504
Practice Address - Street 1:497 BUSHKILL PLAZA LN
Practice Address - Street 2:
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-9665
Practice Address - Country:US
Practice Address - Phone:610-863-7020
Practice Address - Fax:610-863-5504
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040815L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010545340003Medicaid
PA0010545340003Medicaid
PA474320Medicare PIN