Provider Demographics
NPI:1376554378
Name:FRANCIS, GUY ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:ANTHONY
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 MILLBURN AVE
Mailing Address - Street 2:STE C5
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3747
Mailing Address - Country:US
Mailing Address - Phone:973-763-2555
Mailing Address - Fax:973-763-2558
Practice Address - Street 1:2130 MILLBURN AVE
Practice Address - Street 2:STE C5
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3747
Practice Address - Country:US
Practice Address - Phone:973-763-2555
Practice Address - Fax:973-763-2558
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8308004Medicaid
NJ042316Medicare ID - Type Unspecified
NJH24772Medicare UPIN