Basic Information
| Provider Information | |||||||||
| NPI: | 1568187458 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRAIOLI | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103B HALSTEAD AVE | ||||||||
| Address2: | |||||||||
| City: | GREENWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068314913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032535450 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 198 FOSTER AVE STE B | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112302134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488468700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2022 | ||||||||
| LastUpdateDate: | 10/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.