Provider Demographics
NPI:1780790956
Name:DEFRANCISCO, JAMES ALAN (DPM)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:DEFRANCISCO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 AVENUE L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4737
Mailing Address - Country:US
Mailing Address - Phone:718-258-1820
Mailing Address - Fax:718-253-6330
Practice Address - Street 1:3010 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4737
Practice Address - Country:US
Practice Address - Phone:718-258-1820
Practice Address - Fax:718-253-6330
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004071213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T51357Medicare UPIN
P43474Medicare ID - Type Unspecified