MEDICARE: MS. DINA M HAMAOUI MPS ATR-BC LCAT

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	102X00000X	Poetry Therapist	001178	NY

General Provider Information

NPI Number	:	1225291750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DINA M HAMAOUI MPS ATR-BC LCAT

Provider Business Mailing Address
First Line	:	4744 VERNON BLVD APT 2R
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5553
Country	:	US
Telephone Number	:	917-402-4226
Fax Number	:

Provider Business Practice Location Address
First Line	:	4744 VERNON BLVD APT 2R
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5553
Country	:	US
Telephone Number	:	917-402-4226
Fax Number	:

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	07/03/2008

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