Individual
DR. MARY ELLEN DEFRANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
316 WASHINGTON BLVD, BANGOR, PA 18013-2700
(610) 599-9000
(610) 599-9119
Mailing address
316 WASHINGTON BLVD, BANGOR, PA 18013-2700
(610) 599-9000
(610) 599-9119
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD067954L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017828960001
—
PA
05
—
0017828960002
—
PA
Enumeration date
04/13/2007
Last updated
07/08/2007
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