Active NPI
Wanda Merab De Freitas Gonzalez
- Behavior Analyst
- Hewlett, NY
National Provider Identifier
1114569266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1295 Broadway
Hewlett, NY 11557-2015 - Phone
- (833) 624-6385
- NPI assigned
- Oct 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1295 Broadway
Hewlett, NY 11557-2015
Mailing address
321 Fortune Blvd
Milford, MA 01757-1750
Phone (508) 478-0207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6175417 | Other | PR | DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Allies Incorporated | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1114569266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 FORTUNE BLVD",
"city": "MILFORD",
"state": "MA",
"postal_code": "017571750",
"telephone_number": "508-478-0207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1295 BROADWAY",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115572015",
"telephone_number": "833-624-6385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE FREITAS GONZALEZ",
"first_name": "WANDA",
"middle_name": "MERAB",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-10",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "6175417",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hewlett, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.