Provider Demographics
NPI:1649583642
Name:FIORITO-GRAFMAN, MELISSA (PHD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FIORITO-GRAFMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 HARRINGTON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-1912
Mailing Address - Country:US
Mailing Address - Phone:201-252-2528
Mailing Address - Fax:
Practice Address - Street 1:294 HARRINGTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-1912
Practice Address - Country:US
Practice Address - Phone:201-252-2528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4795103G00000X
NY018313103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist