Provider Demographics
NPI:1447234604
Name:MAYLE, FRANCIS C III (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:C
Last Name:MAYLE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2044 ROUTE 32
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MODENA
Mailing Address - State:NY
Mailing Address - Zip Code:12548
Mailing Address - Country:US
Mailing Address - Phone:845-883-5176
Mailing Address - Fax:845-883-5177
Practice Address - Street 1:2044 ROUTE 32
Practice Address - Street 2:SUITE 4
Practice Address - City:MODENA
Practice Address - State:NY
Practice Address - Zip Code:12548
Practice Address - Country:US
Practice Address - Phone:845-883-5176
Practice Address - Fax:845-883-5177
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY158508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10031757OtherCDPHP
NY0000000003010OtherGHI HMO
NY141805299001OtherTRICARE
NY5902624OtherGHI
NYP494012OtherOXFORD
NY000470900001OtherBLUE SHIELD OF NORTHEASTN
NY25562OtherLOCAL 825
NY00852979Medicaid
NY087050OtherMVP
NY575120OtherAETNA-USHC
NY00852979Medicaid
NY25562OtherLOCAL 825