1710336110 NPI number — CHELSEA TOWNES-FRANCIS DDS, MPH

Table of content: CHELSEA TOWNES-FRANCIS DDS, MPH (NPI 1710336110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710336110 NPI number — CHELSEA TOWNES-FRANCIS DDS, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOWNES-FRANCIS
Provider First Name:
CHELSEA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TOWNES
Provider Other First Name:
CHELSEA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS, MPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710336110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
256 VILLAGE GRN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PATCHOGUE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11772-3083
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 MAIN ST # 315-I
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLBROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11741-1524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-254-5437
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2016

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: 1223P0221X , with the licence number:  059846 , 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)