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NPI Code Detail

MEDICARE: KAYLA MARIE ACEVEDO MA

MEDICARE: KAYLA MARIE ACEVEDO MA
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
1221700000XArt Therapist003213NY

General Provider Information

NPI Number : 1568292928
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA MARIE ACEVEDO MA
Provider Business Mailing Address
First Line : 454 KIRBYTOWN RD
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-8605
Country : US
Telephone Number : 845-741-3171
Fax Number :
Provider Business Practice Location Address
First Line : 275 N MIDDLETOWN RD STE 1D
Second Line :
City : PEARL RIVER
State : NY
Zip : 10965-1189
Country : US
Telephone Number : 845-793-2657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2024
Last Update Date : 05/17/2026

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