Basic Information
| Provider Information | |||||||||
| NPI: | 1871517177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PORRECA | ||||||||
| FirstName: | FRANCIS | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., F.A.C.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3219 EAST TREMONT AVENUE | ||||||||
| Address2: | STE 1 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187928115 | ||||||||
| FaxNumber: | 7187922652 | ||||||||
| Practice Location | |||||||||
| Address1: | 3219 E TREMONT AVE | ||||||||
| Address2: | STE 1 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104615751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187928115 | ||||||||
| FaxNumber: | 7187922652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 02/14/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 140780 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00823749 | 05 | NY | MEDICAID |