Healthcare Provider Details

I. General information

NPI: 1255508412
Provider Name (Legal Business Name): FRANCO JOSEPH MANISCALCO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6430 ROCKLEDGE DR. SUITE 160
BETHESDA MD
20817
US

IV. Provider business mailing address

68 SOUTH SERVICE ROAD SUITE 350
MELVILLE NY
11747
US

V. Phone/Fax

Practice location:
  • Phone: 301-312-6144
  • Fax:
Mailing address:
  • Phone: 516-945-3000
  • Fax: 516-945-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number145607-30
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number13676
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number182305
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAC001450
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: