Provider Demographics
NPI:1720729668
Name:PALER-LARGE, FRANCISCO
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:PALER-LARGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 JACKSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TRUMANSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14886-9034
Mailing Address - Country:US
Mailing Address - Phone:607-793-7383
Mailing Address - Fax:
Practice Address - Street 1:318 N AURORA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4274
Practice Address - Country:US
Practice Address - Phone:607-391-0162
Practice Address - Fax:607-391-0162
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103388101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health