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General NPI Number Information
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NPI Number | 1477026623
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Entity Type | Individual
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Provider Name | ALFREDO FUCCILLI JR. BCBA
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Gender | Male
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1150 RTE 22 STE 110
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2966
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Country | US
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Telephone | 855-777-6480
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Fax |
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Provider Business Mailing Address
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Address Line | 542 AMHERST ST STE B
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City | NASHUA
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State | NH
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Zip | 03063-1016
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Country | US
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Telephone | 561-323-6593
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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