Provider Demographics
NPI:1336651629
Name:PANELY, FRANCINE (PA)
Entity Type:Individual
Prefix:MR
First Name:FRANCINE
Middle Name:
Last Name:PANELY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 NEPTUNE AVE APT 18R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4325
Mailing Address - Country:US
Mailing Address - Phone:917-903-3329
Mailing Address - Fax:718-996-4661
Practice Address - Street 1:460 NEPTUNE AVE APT 18R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-4325
Practice Address - Country:US
Practice Address - Phone:917-903-3329
Practice Address - Fax:718-996-4661
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01756363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical