Provider Demographics
NPI:1811193113
Name:DEFRANCO, JEAN ELIZABETH (LPN)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ELIZABETH
Last Name:DEFRANCO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-6014
Mailing Address - Country:US
Mailing Address - Phone:914-310-0834
Mailing Address - Fax:
Practice Address - Street 1:1531 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-6014
Practice Address - Country:US
Practice Address - Phone:914-310-0834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237546164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02069294Medicaid