Healthcare Provider Details

I. General information

NPI: 1346316775
Provider Name (Legal Business Name): ELIZABETH MARIE CARNAVAL LCAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH MARIE HOLMES LCAT, ATR

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 01/18/2025
Certification Date: 01/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 FRANKLIN AVE
GARDEN CITY NY
11530-2927
US

IV. Provider business mailing address

21 NORCROSS ST
ROCKVILLE CENTRE NY
11570-1926
US

V. Phone/Fax

Practice location:
  • Phone: 347-534-6671
  • Fax:
Mailing address:
  • Phone: 347-534-6671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number000141
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: