Healthcare Provider Details

I. General information

NPI: 1629124334
Provider Name (Legal Business Name): FRANKLINVILLE CSD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 N. MAIN ST
FRANKLINVILLE NY
14737-1038
US

IV. Provider business mailing address

31 N. MAIN ST
FRANKLINVILLE NY
14737-1038
US

V. Phone/Fax

Practice location:
  • Phone: 716-676-8028
  • Fax: 716-676-8041
Mailing address:
  • Phone: 716-676-8028
  • Fax: 716-676-8041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DANIELE VECCHIO
Title or Position: BUSINESS OFFICIAL
Credential:
Phone: 716-676-8028