Provider Demographics
NPI:1053885145
Name:FRANCIS, MARIA (APRN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 ROUTE 112 STE 101
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-8054
Mailing Address - Country:US
Mailing Address - Phone:631-751-3000
Mailing Address - Fax:631-751-0506
Practice Address - Street 1:12 E 86TH ST OFC 4C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0517
Practice Address - Country:US
Practice Address - Phone:212-861-6660
Practice Address - Fax:631-751-0506
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11000159363LF0000X
NY344151363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11000159OtherAPRN