Provider Demographics
NPI:1780013326
Name:FRANCZYK, MARK (COTA)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:FRANCZYK
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 PEINKOFER DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2226
Mailing Address - Country:US
Mailing Address - Phone:716-908-4666
Mailing Address - Fax:
Practice Address - Street 1:137 PEINKOFER DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2226
Practice Address - Country:US
Practice Address - Phone:716-908-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008200-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant