Provider Demographics
NPI:1174572424
Name:FRANCO, LEONARD S (MD)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:S
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:ELLICOTTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14731-0248
Mailing Address - Country:US
Mailing Address - Phone:716-699-9032
Mailing Address - Fax:
Practice Address - Street 1:207 FOOTE AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-7077
Practice Address - Country:US
Practice Address - Phone:716-487-1124
Practice Address - Fax:716-487-2488
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145426207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00761986Medicaid
NY00761986Medicaid