Healthcare Provider Details

I. General information

NPI: 1922151562
Provider Name (Legal Business Name): BRENDAN MICHAEL ORMSBY LCAT, MT-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 WALDO AVE APT 5K
BRONX NY
10463-2224
US

IV. Provider business mailing address

3660 WALDO AVE APT 5K
BRONX NY
10463-2224
US

V. Phone/Fax

Practice location:
  • Phone: 646-673-7058
  • Fax:
Mailing address:
  • Phone: 646-673-7058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number001064
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: