Provider Demographics
NPI:1336353630
Name:FRANCAVILLA, FRANK NICHOLAS
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:NICHOLAS
Last Name:FRANCAVILLA
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 1:97 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZAVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12523-1334
Mailing Address - Country:US
Mailing Address - Phone:845-756-2320
Mailing Address - Fax:
Practice Address - Street 1:2094 ALBANY POST RD
Practice Address - Street 2:BLDG. 12, 1ST FLOOR
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1454
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4293
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066252-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical