1841593423 NPI number — MRS. JEAN KERNAN FRANCISCO OTR/CHT

Table of content: MRS. JEAN KERNAN FRANCISCO OTR/CHT (NPI 1841593423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841593423 NPI number — MRS. JEAN KERNAN FRANCISCO OTR/CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCISCO
Provider First Name:
JEAN
Provider Middle Name:
KERNAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR/CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRANCISCO
Provider Other First Name:
JEAN
Provider Other Middle Name:
KERNAN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/CHT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1841593423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
239 GENESEE ST STE 1
Provider Second Line Business Mailing Address:
6219 COLEMAN MILLS RD.
Provider Business Mailing Address City Name:
CHITTENANGO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13037-1704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-510-3372
Provider Business Mailing Address Fax Number:
315-510-3688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
239 GENESEE ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
CHITTENANGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13037-1704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-510-3372
Provider Business Practice Location Address Fax Number:
315-510-3688
Provider Enumeration Date:
12/21/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  008057-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1841593423 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1477782589 . This is a "GROUP NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6312360001 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".