MEDICARE: JOHN STELLARD 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	225600000X	Dance Therapist	003179	NY

General Provider Information

NPI Number	:	1770454795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN STELLARD LCAT

Provider Business Mailing Address
First Line	:	98 PARK TER E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10034-1417
Country	:	US
Telephone Number	:	917-336-2785
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 PARK TER E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10034-1417
Country	:	US
Telephone Number	:	917-336-2785
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	05/21/2026

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Directions to “ JOHN STELLARD LCAT” Practice Location

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