MICHELLE FANCIULLO (NPI# 1144831082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144831082 |
| Entity Type | Individual |
| Full Name | MICHELLE FANCIULLO |
| Credential | PSY.D. |
| Practice Address |
12 2nd St Hackensack NJ 07601-2009 |
| Mailing Address |
30 Prospect Ave Hackensack NJ 07601-1915 |
| Practice Telephone | 5519968186 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
35SI00623300 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
12 2ND ST |
| City | HACKENSACK |
| State | NJ |
| Zip Code | 07601-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255398 | Amanda Addolorato Macdonald | Psychologist | 12 2nd St, Hackensack, NJ 07601-2009 | 2020-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989414 | Alpha Healthcare Staffing Firm, LLC | Registered Nurse | 194 Passaic Street, Hackensack, NJ 07601 | 2020-10-15 |
| 1396350120 | Lower Limb Institute | Podiatrist | 211 Esses Street, Suite 405, Hackesack, NJ 07601 | 2020-09-09 |
| 1649825233 | Rachel Korenblit | Social Worker | 235 Main St Ste 203, Hackensack, NJ 07601 | 2019-08-09 |
| 1740846567 | Samantha Pirnat | Counselor | 426 Hudson Street, 2nd Floor, Hackensack, NJ 07601 | 2019-05-16 |
| 1881258499 | Tara Lynn Smith | Social Worker | 160 South River Street, Hackensack, NJ 07601 | 2019-04-29 |
| 1922569318 | Solomon Isakov | Dentist | 835 Prospect Ave, Suite 304, Hackensack, NJ 07601 | 2019-03-27 |
| 1114403409 | Mildred Lopez Vasquez | Home Health Aide | 12 Rowland Avenue, Hackensack, NJ 07601 | 2018-07-19 |
| 1538656582 | Zara Pharmacy LLC | Pharmacy | 57 Linden St, Hackensack, NJ 07601 | 2018-04-16 |
| 1447759048 | Maryann Hom | Social Worker | 307 Prospect Avenue, 14e, Hackensack, NJ 07601 | 2018-02-08 |
| 1699274258 | Kirsten Byrnes | Psychologist | Audrey Hepburn Children's House, Hackensack Umc, 12 Second St, Hackensack, NJ 07601 | 2018-02-08 |
| Find all providers in zip 07601 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548879984 | Pm Vietze Phd LLC | Psychologist | 957 Cedarbrook Road, Plainfield, NJ 07060-2646 | 2020-07-30 |
| 1275159642 | Family Home Care Services LLC | Psychologist | 7 Glenwood Ave Ste 419c, East Orange, NJ 07017-1065 | 2020-06-22 |
| 1326675034 | Jennifer Yedlin | Psychologist | 540 Queen Anne Rd, Teaneck, NJ 07666-3329 | 2020-03-24 |
| 1558835876 | Jacqueline D Freedman | Psychologist | 748 Morris Tpke Ste 207, Short Hills, NJ 07078-2617 | 2019-01-21 |
| 1669942777 | Psychological & Educational Consulting | Psychologist | 513 W Mount Pleasant Ave Ste 212, Livingston, NJ 07039-1721 | 2018-12-01 |
| 1467949735 | Courtney Anderson, Psyd, LLC | Psychologist | 256 Read St, Lakewood, NJ 08701-5327 | 2018-04-22 |
| 1790282192 | Stefan C. Dombrowski, Ph.d. & Associates, LLC | Psychologist | 4 Eves Dr, Marlton, NJ 08053-3195 | 2018-04-11 |
| 1104338813 | Suzi Millar | Psychologist | 50 Boulevard of Eagles, Edison, NJ 08817-4002 | 2017-11-03 |
| 1750893954 | Tishanna D Majette Phd Corporation | Psychologist | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054 | 2017-10-27 |
| 1477965457 | Courtney Anderson | Psychologist | 40 Avenue At The Cmn Ste 203, Shrewsbury, NJ 07702 | 2014-05-27 |
| Find all providers with the same taxonomy | ||||
| City | HACKENSACK |
| Zip Code | 07601 |
Please comment or provide details below to improve the information on MICHELLE FANCIULLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.