1538323985 NPI number — JANELLE RAE FRANCISCO M.S., ATC

Table of content: JANELLE RAE FRANCISCO M.S., ATC (NPI 1538323985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538323985 NPI number — JANELLE RAE FRANCISCO M.S., ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCISCO
Provider First Name:
JANELLE
Provider Middle Name:
RAE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538323985
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
335 CENTER RD
Provider Second Line Business Mailing Address:
APT 5D
Provider Business Mailing Address City Name:
VERNON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06066-4178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-983-0266
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2111 HILLSIDE RD
Provider Second Line Business Practice Location Address:
U-3078
Provider Business Practice Location Address City Name:
STORRS MANSFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06269-9002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-486-2520
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2008

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: 2255A2300X , with the licence number:  000555 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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