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General NPI Number Information
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NPI Number | 1366227332
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Entity Type | Individual
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Provider Name | SANDRA ANGILLETTA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 11 GLEANER LN
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City | LEVITTOWN
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State | NY
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Zip | 11756-5107
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Country | US
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Telephone | 516-588-6115
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 80TH ST
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City | BROOKLYN
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State | NY
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Zip | 11228-2619
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Country | US
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Telephone | 347-963-0406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 002564
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License Number State | NY
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