Healthcare Provider Details

I. General information

NPI: 1417436619
Provider Name (Legal Business Name): MICHAEL JOSEPH INFRANCO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 FRANKLIN ST
BUFFALO NY
14202-1507
US

IV. Provider business mailing address

387 FRANKLIN ST
BUFFALO NY
14202-1507
US

V. Phone/Fax

Practice location:
  • Phone: 716-462-0284
  • Fax:
Mailing address:
  • Phone: 716-462-0284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number022753
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: