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General NPI Number Information
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NPI Number | 1619314101
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Entity Type | Individual
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Provider Name | VANETTA LAROSA BCBA-D
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Gender | Female
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Dates
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Enumeration Date | 05/24/2013
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 315 W 57TH ST STE 401
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City | NEW YORK
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State | NY
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Zip | 10019-3147
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Country | US
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Telephone | 516-659-5041
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Fax |
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Provider Business Mailing Address
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Address Line | 160 E MAIN ST REAR BUILDING
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City | HUNTINGTON
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State | NY
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Zip | 11743-7400
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Country | US
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Telephone | 631-659-3337
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Fax | 631-659-3338
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 026443
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 026443
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 026443
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 026443
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-03-1115
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License Number State | NY
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