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Individual

MARK DEFRANCESCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
60 WESTWOOD AVE, SUITE 200, WATERBURY, CT 06708
(203) 574-5501
(203) 596-0912
Mailing address
60 WESTWOOD AVE, SUITE 200, WATERBURY, CT 06708
(203) 574-5501
(203) 596-0912

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
023375
CT
207VG0400X
Gynecology Physician
Primary
023375
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001233758
CT
Enumeration date
08/18/2006
Last updated
01/11/2012
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