Healthcare Provider Details

I. General information

NPI: 1669722757
Provider Name (Legal Business Name): RICHMOND MUSIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2012
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 PAGE AVE
STATEN ISLAND NY
10309-2611
US

IV. Provider business mailing address

25 PAGE AVE
STATEN ISLAND NY
10309-2611
US

V. Phone/Fax

Practice location:
  • Phone: 718-967-4686
  • Fax:
Mailing address:
  • Phone: 718-967-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH PICCINNINI
Title or Position: PRESIDENT
Credential: MA, LCAT,CMT
Phone: 718-967-4686