Provider Demographics
NPI:1952453839
Name:DEFRANCO, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:DEFRANCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 HAMBURG TPKE
Mailing Address - Street 2:WAYNE COMMONS, SUITE 101
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2025
Mailing Address - Country:US
Mailing Address - Phone:973-942-6005
Mailing Address - Fax:973-942-6009
Practice Address - Street 1:510 HAMBURG TPKE
Practice Address - Street 2:WAYNE COMMONS, SUITE 101
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2025
Practice Address - Country:US
Practice Address - Phone:973-942-6005
Practice Address - Fax:973-942-6009
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08195300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2833226000OtherAMERIHEALTH #
NJ3K6390OtherHEALTHNET #
NJP00406558OtherRAILROAD MEDICARE
NJP3787752OtherOXFORD
NJ1501301OtherAETNA HMO #
NJ659AZ1OtherEMPIRE BC/BS #
NJ7049800OtherAETNA PPO #
NJ223806823OtherTAX ID#
NJ2833226000OtherAMERIHEALTH #
NJI49465Medicare UPIN