Elissa Ann Matrisciano

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1691 Issued in CT

Practice address

18 Flanders Rd
East Hampton, CT 06424-6617

Phone

(845) 222-3898

NPI assigned

May 14, 2019

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1487210662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FLANDERS RD",
            "city": "EAST HAMPTON",
            "state": "CT",
            "postal_code": "064246617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 FLANDERS RD",
            "city": "EAST HAMPTON",
            "state": "CT",
            "postal_code": "064246617",
            "telephone_number": "845-222-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATRISCIANO",
        "first_name": "ELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2024-12-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "5156",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Luzzi, BCBA
• Rachel Susan Madore, DO
• Mariann Mankowski, MSW, PH.D.
• George M. Mantikas, D.M.D.
• Maya Rainie Marozzi
• Julie Mazzone, LMFT
• Cheri McKenna
• Judith Marie Mezzomo, PT
• Middlesex Hospital Dba Family Practice Group East Hampton (Family Practice Group East Hampton)
• Maryann Millette, LPC

• Behavior Analyst in East Hampton, CT
• Providers in East Hampton, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.