Individual provider Active NPI

Theresa Anne Raniello

  • Behavior Analyst
  • Merrick, NY
National Provider Identifier
1306228770
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11417067 Issued in NY
Practice address
1574 N Jerusalem Rd
Merrick, NY 11566-1210
Phone
(631) 873-6311
NPI assigned
Jun 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 11417067 NY Primary

Addresses

Primary practice location

1574 N Jerusalem Rd
Merrick, NY 11566-1210

Mailing address

1574 N Jerusalem Rd
Merrick, NY 11566-1210
Phone (631) 873-6311

Other names 1

  • Mrs. Theresa Anne Raniello Former name

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

State licenses

LicenseStateTypeSpecialty
11417067NYMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1306228770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 N JERUSALEM RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661210",
            "telephone_number": "631-873-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 N JERUSALEM RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661210",
            "telephone_number": "631-873-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANIELLO",
        "first_name": "THERESA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "11417067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "RANIELLO",
            "middle_name": "ANNE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.