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General NPI Number Information
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NPI Number | 1003170994
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Entity Type | Individual
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Provider Name | ETTY FROMOWITZ MS ED
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Gender | Female
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1312 38TH ST
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City | BROOKLYN
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State | NY
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Zip | 11218-3612
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Country | US
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Telephone | 718-686-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 5366 BRANTFORD AVE
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City | MEMPHIS
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State | TN
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Zip | 38120-2440
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Country | US
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Telephone | 845-641-0022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 251129423
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 000192
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License Number State | NY
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