Healthcare Provider Details

I. General information

NPI: 1972827616
Provider Name (Legal Business Name): DEBORAH STONE MS, BC-DMT, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 BROADWAY 11D
NEW YORK NY
10003-9500
US

IV. Provider business mailing address

123 W 80TH ST APT. 3R
NEW YORK NY
10024-7137
US

V. Phone/Fax

Practice location:
  • Phone: 917-334-7745
  • Fax:
Mailing address:
  • Phone: 917-334-7745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number000794
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: