Provider Demographics
NPI:1154487510
Name:FRANCISCUS, MICHAEL S (ATC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:FRANCISCUS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4237
Mailing Address - Country:US
Mailing Address - Phone:908-720-2884
Mailing Address - Fax:
Practice Address - Street 1:855 GROVE AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2201
Practice Address - Country:US
Practice Address - Phone:732-452-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000873002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer