Provider Demographics
NPI:1982644266
Name:ANDREW J. LAFRANCE
Entity Type:Organization
Organization Name:ANDREW J. LAFRANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LAFRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:315-562-3111
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:NY
Mailing Address - Zip Code:13635-0031
Mailing Address - Country:US
Mailing Address - Phone:315-562-3111
Mailing Address - Fax:315-562-2111
Practice Address - Street 1:20 TROUT LAKE ROAD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:NY
Practice Address - Zip Code:13635-0031
Practice Address - Country:US
Practice Address - Phone:315-562-3111
Practice Address - Fax:315-562-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01746189Medicaid
NYBA0881Medicare PIN
NY01746189Medicaid