Provider Demographics
NPI:1194442947
Name:FRANCO, PEYTON
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:FRANCO
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 1:2339 WILLOUGHBY AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2927
Mailing Address - Country:US
Mailing Address - Phone:516-506-3931
Mailing Address - Fax:
Practice Address - Street 1:972 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705-1612
Practice Address - Country:US
Practice Address - Phone:631-472-2629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118009-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker