Provider Demographics
NPI:1215107735
Name:FRANCISCO, CLEA C
Entity type:Individual
Prefix:
First Name:CLEA
Middle Name:C
Last Name:FRANCISCO
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 1:500 GRAND AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4967
Mailing Address - Country:US
Mailing Address - Phone:201-227-1706
Mailing Address - Fax:201-567-2639
Practice Address - Street 1:500 GRAND AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4967
Practice Address - Country:US
Practice Address - Phone:201-227-1706
Practice Address - Fax:201-567-2639
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist