Provider Demographics
NPI:1134764251
Name:FRANCISCO, GRECHIELLA MADEJA (RN)
Entity type:Individual
Prefix:
First Name:GRECHIELLA
Middle Name:MADEJA
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 KNIGHTS BRG APT E
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-9417
Mailing Address - Country:US
Mailing Address - Phone:518-709-3482
Mailing Address - Fax:
Practice Address - Street 1:20 KNIGHTS BRG APT E
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-9417
Practice Address - Country:US
Practice Address - Phone:518-709-3482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY847545163W00000X
NY326995-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1134764251Medicaid