Individual
KENNETH PATRICK FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA, LBA
Contact information
Practice address
354 VETERANS MEMORIAL HWY STE 3, COMMACK, NY 11725-4331
(516) 220-1049
Mailing address
61 REDMOND AVE, BAY SHORE, NY 11706-6810
(631) 968-0105
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002466
NY
103K00000X
Behavior Analyst
1-20-44448
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/01/2021
Last updated
01/18/2023
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