MEDICARE: MR. CARL F DEFRANCO II PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	402648	NY

General Provider Information

NPI Number	:	1033777867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL F DEFRANCO II PMHNP

Provider Business Mailing Address
First Line	:	646 N FRENCH RD STE 7
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14228-2100
Country	:	US
Telephone Number	:	716-345-4125
Fax Number	:	716-229-3903

Provider Business Practice Location Address
First Line	:	646 N FRENCH RD STE 7
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14228-2100
Country	:	US
Telephone Number	:	716-345-4125
Fax Number	:	716-229-3903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2019
Last Update Date	:	12/05/2024

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