MEDICARE: LEROY VAUGHN FRANCE PA

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	363A00000X	Physician Assistant	0007731	NY

General Provider Information

NPI Number	:	1992948624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEROY VAUGHN FRANCE PA

Provider Business Mailing Address
First Line	:	100 LIVINGSTON ST STE 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5023
Country	:	US
Telephone Number	:	718-875-1144
Fax Number	:	718-875-1002

Provider Business Practice Location Address
First Line	:	100 LIVINGSTON ST STE 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5023
Country	:	US
Telephone Number	:	718-875-1144
Fax Number	:	718-875-1002

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

Provider Enumeration Date	:	04/10/2009
Last Update Date	:	02/24/2017

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