Provider Demographics
NPI:1457101743
Name:DEFRANCO, DAVID A (BCBA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:DEFRANCO
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SPEIR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1023
Mailing Address - Country:US
Mailing Address - Phone:973-738-2518
Mailing Address - Fax:
Practice Address - Street 1:12 GOLDBLATT TER
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-1416
Practice Address - Country:US
Practice Address - Phone:973-885-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-24-71678103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst