Demitria Athena Fragale, BCBA, LBA-NY
Individual provider Active NPI Behavior Analyst · Marlboro, NY
NPI 1811780596 · NPPES record last updated May 27, 2025
Key facts
- NPI
- 1811780596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 003647 (NY)
- Practice address
- 66 Hudson Ter
Marlboro, NY 12542-6139 - Phone
- (517) 243-1041
- NPI assigned
- May 27, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003647 | NY | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 003647 | NY | Yes |
Addresses
Primary practice location
66 Hudson Ter
Marlboro, NY 12542-6139
Mailing address
66 Hudson Ter
Marlboro, NY 12542-6139
Phone (517) 243-1041
Other providers in Marlboro, NY
- Gina Dowden
- Ammie Duwai-King
- Kiana Edwards
- Nino A Elizondo
- Tara Denise Farina
- Megan Anne Gebert
- Erin Nicole Gephard
- Gerard Matthew OT PC
- Melissa Ann Gorski
- Shana Griffin
All providers in Marlboro, NY · Behavior Analyst in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.