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NPI Code Detail

MEDICARE: DR. STACEY LEA DONFRANCESCO D.O.

MEDICARE: DR. STACEY LEA DONFRANCESCO D.O.
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
1208600000XSurgery PhysicianOT014237PA

General Provider Information

NPI Number : 1710272448
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STACEY LEA DONFRANCESCO D.O.
Provider Business Mailing Address
First Line : 4601 FLAT ROCK RD
Second Line : UNIT 16
City : PHILADELPHIA
State : PA
Zip : 19127-2027
Country : US
Telephone Number : 401-829-8256
Fax Number :
Provider Business Practice Location Address
First Line : 4170 CITY AVE
Second Line : DEPARTMENT OF GRADUATE MEDICAL EDUCATION - ROWLAND HALL
City : PHILADELPHIA
State : PA
Zip : 19131-1610
Country : US
Telephone Number : 215-871-6693
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2011
Last Update Date : 06/10/2011

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