Organization Name: | KIMBERLY A. FRASCA, PSY.D. PC |
NPI Number: | 1851713556 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIMBERLY ANN FRASCA (PRESIDENT) |
Mailing Address: | 3771 Nesconset Hwy Suite 208a South Setauket |
State: | NY US |
Postal Code: | 117201163 |
Phone Number: | 6319051254 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2014 |
NPI Last Update Date: | 01/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 018606 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |