Active NPI
Malissa McConnell
- Behavior Analyst
- East Setauket, NY
National Provider Identifier
1366818403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 34 Cabin LN
East Setauket, NY 11733-3442 - Phone
- (631) 871-8629
- NPI assigned
- Aug 12, 2015
- 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
34 Cabin LN
East Setauket, NY 11733-3442
Mailing address
34 Cabin LN
East Setauket, NY 11733-3442
Phone (631) 871-8629
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439337600000",
"number": "1366818403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 CABIN LN",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333442",
"telephone_number": "631-871-8629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 CABIN LN",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333442",
"telephone_number": "631-871-8629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "MALISSA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-12",
"last_updated": "2015-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.