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General NPI Number Information
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NPI Number | 1114415510
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Entity Type | Organization
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Legal Business Name | MATTHEW FRANCO O.T.P.C.
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 5 AVON DR
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2103
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Country | US
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Telephone | 631-828-0831
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Fax |
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Provider Business Mailing Address
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Address Line | 5 AVON DR
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2103
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Country | US
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Telephone | 631-828-0831
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW R FRANCO
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Credential | OCCUPATIONAL THERAPI
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Telephone | 631-828-0831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 007898-1
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License Number State | NY
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