Provider Demographics
NPI:1740723600
Name:FRANCO, ELDA LILIAN (CDN)
Entity type:Individual
Prefix:MS
First Name:ELDA
Middle Name:LILIAN
Last Name:FRANCO
Suffix:
Gender:F
Credentials:CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3018 43RD ST
Mailing Address - Street 2:APT. 11
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2642
Mailing Address - Country:US
Mailing Address - Phone:516-743-6025
Mailing Address - Fax:
Practice Address - Street 1:14732 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4042
Practice Address - Country:US
Practice Address - Phone:718-349-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008261133N00000X
NYF001976-01176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1194832949OtherNPI