Healthcare Provider Details

I. General information

NPI: 1134707136
Provider Name (Legal Business Name): JOHANNA FRANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MAPLE AVE
ROCKVILLE CTR NY
11570-4274
US

IV. Provider business mailing address

55 MAPLE AVE
ROCKVILLE CTR NY
11570-4274
US

V. Phone/Fax

Practice location:
  • Phone: 347-208-6336
  • Fax:
Mailing address:
  • Phone: 516-639-4925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number030952
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: