Provider Demographics
NPI:1417155243
Name:DEFRANCISCI, LEA ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:ELIZABETH
Last Name:DEFRANCISCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEA
Other - Middle Name:DEFRANCISCI
Other - Last Name:LIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:46 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-4864
Mailing Address - Country:US
Mailing Address - Phone:631-204-6984
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-4864
Practice Address - Country:US
Practice Address - Phone:631-204-6984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2383372084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry