Provider Demographics
NPI:1194293217
Name:FUTTERMAN, FRANCINE RONA
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:RONA
Last Name:FUTTERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 VOORHIS DR
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1032
Mailing Address - Country:US
Mailing Address - Phone:631-897-0706
Mailing Address - Fax:
Practice Address - Street 1:54 VOORHIS DR
Practice Address - Street 2:
Practice Address - City:OLD BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11804-1032
Practice Address - Country:US
Practice Address - Phone:631-897-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health