Provider Demographics
NPI:1992331102
Name:NANCY DIFRANCESCO LLC
Entity type:Organization
Organization Name:NANCY DIFRANCESCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIFRANCESCO
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:856-906-2726
Mailing Address - Street 1:236 SYLVAN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-3909
Mailing Address - Country:US
Mailing Address - Phone:856-906-2726
Mailing Address - Fax:
Practice Address - Street 1:6 WHITE HORSE PIKE STE 2A
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1246
Practice Address - Country:US
Practice Address - Phone:856-300-2587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health