MEDICARE: MS. HEATHER A GENOVESE MS, ATR-BC, LCAT,LP

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	221700000X	Art Therapist	000004-1	NY
2	102L00000X	Psychoanalyst	000864	NY

General Provider Information

NPI Number	:	1982780698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER A GENOVESE MS, ATR-BC, LCAT,LP

Provider Business Mailing Address
First Line	:	850 SEVENTH AVE
Second Line	:	SUITE 906
City	:	NEW YORK
State	:	NY
Zip	:	10019-5230
Country	:	US
Telephone Number	:	212-289-5644
Fax Number	:	212-289-5644

Provider Business Practice Location Address
First Line	:	850 SEVENTH AVE
Second Line	:	SUITE 906
City	:	NEW YORK
State	:	NY
Zip	:	10019-5230
Country	:	US
Telephone Number	:	212-289-5644
Fax Number	:	212-289-5644

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	03/31/2011

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