MEDICARE: FALYN M FIORITO MS, BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-17-29090	IL

General Provider Information

NPI Number	:	1396246971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALYN M FIORITO MS, BCBA

Provider Business Mailing Address
First Line	:	6405 MCINTOSH CT
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-6815
Country	:	US
Telephone Number	:	618-967-8859
Fax Number	:

Provider Business Practice Location Address
First Line	:	6405 MCINTOSH CT
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-6815
Country	:	US
Telephone Number	:	618-967-8859
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2018
Last Update Date	:	03/05/2026

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