Provider Demographics
NPI:1407110331
Name:FRALLICCIARDI, DEBORAH (MS EDUCATION)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:FRALLICCIARDI
Suffix:
Gender:F
Credentials:MS EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LASER CT
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3958
Mailing Address - Country:US
Mailing Address - Phone:631-853-2342
Mailing Address - Fax:631-853-2310
Practice Address - Street 1:50 LASER CT
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3958
Practice Address - Country:US
Practice Address - Phone:631-853-2342
Practice Address - Fax:631-853-2310
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator