Provider Demographics
NPI:1194920439
Name:FRANCISCO, JOSEPH R (HIS)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:R
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2115
Mailing Address - Country:US
Mailing Address - Phone:215-336-7995
Mailing Address - Fax:
Practice Address - Street 1:29 S NEW YORK RD STE 1000
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205
Practice Address - Country:US
Practice Address - Phone:609-404-1550
Practice Address - Fax:609-377-5108
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO3145237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1561141OtherHIGHMARK BLUE SHIELD ID