Provider Demographics
NPI:1891473146
Name:FRANCISCO, FERNANDO A (LMT)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:A
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 MIDLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4751
Mailing Address - Country:US
Mailing Address - Phone:631-745-8951
Mailing Address - Fax:
Practice Address - Street 1:8701 MIDLAND PKWY
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4751
Practice Address - Country:US
Practice Address - Phone:631-745-8951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023845-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist