Healthcare Provider Details
I. General information
NPI: 1255193298
Provider Name (Legal Business Name): MOLLY ELIZABETH FARRUGIA LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/25/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
252 JAVA ST STE 217
BROOKLYN NY
11222-5598
US
IV. Provider business mailing address
985 BERGEN ST APT 2
BROOKLYN NY
11216-5496
US
V. Phone/Fax
- Phone: 929-205-4253
- Fax:
- Phone: 443-841-5587
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | 003184-01 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: