MEDICARE: FANTASHIA BEST

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1811860117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FANTASHIA BEST

Provider Business Mailing Address
First Line	:	2318 E MAIN ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-1801
Country	:	US
Telephone Number	:	475-455-1769
Fax Number	:

Provider Business Practice Location Address
First Line	:	2318 E MAIN ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-1801
Country	:	US
Telephone Number	:	475-455-1769
Fax Number	:

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

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	10/24/2025

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Directions to “ FANTASHIA BEST ” Practice Location

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