Provider Demographics
NPI:1407843063
Name:DIFRANCEISCO, DAVID (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DIFRANCEISCO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 PHILMONT AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5321
Mailing Address - Country:US
Mailing Address - Phone:215-938-7878
Mailing Address - Fax:215-938-7985
Practice Address - Street 1:2755 PHILMONT AVE STE 140
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5321
Practice Address - Country:US
Practice Address - Phone:215-938-7878
Practice Address - Fax:215-938-7985
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000964152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001787589Medicaid
PA406752Medicare ID - Type Unspecified
PA001787589Medicaid