Doctor Name: | JENNIFER FUNICIELLO-YANAZZO |
NPI Number: | 1528311693 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED, BCBA |
License Number: | 1-09-5912 |
Business Practice Address: | 100 Saratoga Village Blvd Ste 35 Malta, NY - 120203738 |
Business Phone Number: | 5188999235 |
Business Fax Number: | |
Mailing Address: | 100 Saratoga Village Blvd Ste 35, MALTA |
State: | NY |
Postal Code: | 120203738 |
Phone Number: | 5188999235 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2012 |
NPI Last Update Date: | 10/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1-09-5912 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |