Provider Demographics
NPI:1578669164
Name:FRANCIS, KATHLEEN D (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:D
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SOUTH ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07309
Mailing Address - Country:US
Mailing Address - Phone:973-322-7366
Mailing Address - Fax:973-322-7450
Practice Address - Street 1:200 SOUTH ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07309
Practice Address - Country:US
Practice Address - Phone:973-322-7366
Practice Address - Fax:973-322-7450
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00231528OtherRAILROAD MEDICARE
NJ8127301Medicaid
132164SWRMedicare ID - Type UnspecifiedINDIVIDUAL
080752Medicare ID - Type UnspecifiedGROUP
NJ8127301Medicaid