Provider Demographics
NPI:1295842300
Name:FRANCIOSA, STEFAN VINCENT (DO)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:VINCENT
Last Name:FRANCIOSA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 DOUBLE R BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-6014
Mailing Address - Country:US
Mailing Address - Phone:775-348-8800
Mailing Address - Fax:775-348-8818
Practice Address - Street 1:9990 DOUBLE R BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-6014
Practice Address - Country:US
Practice Address - Phone:775-348-8800
Practice Address - Fax:775-348-8818
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0120482085R0202X
NJMB085324002085R0202X
NVDO20192085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS012048OtherPA LICENSE NUMBER
NJMB08532400OtherNJ LICENSE
NVDO2019OtherNV LICENSE
BF8312693OtherDEA
PAOS012048OtherPA LICENSE NUMBER
NJFF1305285OtherNJ DEA