Provider Demographics
NPI:1669013736
Name:DEFRANCO, MATTHEW PATRICK
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PATRICK
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 1:124 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-1714
Mailing Address - Country:US
Mailing Address - Phone:516-761-2215
Mailing Address - Fax:
Practice Address - Street 1:300 GARDEN CITY PLZ STE 350
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3358
Practice Address - Country:US
Practice Address - Phone:516-761-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002525103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst