DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICOLE ASHLEY PETILLO, BCBA, LBA

Active Sole Proprietor

NICOLE ASHLEY PETILLO, BCBA, LBA is a Behavior Analyst healthcare provider located in CORAM, New York. NPI 1366271843 is currently active in the NPPES registry. Verify at CMS.

Behavior Analyst · CORAM, NY

Registration Details

NPI Number
1366271843
Provider Type
Individual
Gender
Female
NPI Issued
Jul 31, 2024 (2.0606805959737 yrs)
Last Updated
Mar 18, 2025
License
004157 (NY)
Sole Proprietor
Yes

Practice Information

Address
5 FILLMORE CT
CORAM, NY, 117273910
Browse NY providers · Browse ZIP 11727
Phone
7188441406
Primary Specialty
Behavior Analyst
103K00000X
Additional Specialty
Behavior Analyst

Other Behavior Analyst Providers in CORAM, NY

Name Credential NPI
MRS. ELIZABETH RATNAMALA BENJAMIN NURSE PRACTIONER 1629382114
HOLLEY YOUNG 1376092239
LISA MARIE ISAAC 1265075774
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.