Provider Demographics
NPI:1538144837
Name:FRANCO, THOMAS (PA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:FRANCO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 983018
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-3018
Mailing Address - Country:US
Mailing Address - Phone:401-553-0339
Mailing Address - Fax:401-633-6268
Practice Address - Street 1:354 BIRNIE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1108
Practice Address - Country:US
Practice Address - Phone:413-733-3470
Practice Address - Fax:413-733-5235
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA862363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P71650Medicare UPIN
970028486Medicare PIN
MAAP1827Medicare PIN