Provider Demographics
NPI:1962523837
Name:COFRANCESCO, LOUIS (DC)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:COFRANCESCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 AMITY RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2236
Mailing Address - Country:US
Mailing Address - Phone:203-397-7767
Mailing Address - Fax:203-397-7768
Practice Address - Street 1:270 AMITY RD
Practice Address - Street 2:SUITE 132
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2236
Practice Address - Country:US
Practice Address - Phone:203-397-7767
Practice Address - Fax:203-397-7768
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000961CT01OtherBLUE CROSS BLUE SHIELD
CT4568578OtherAETNA
CT4568578OtherAETNA