MEDICARE: MR. JOSEPH PAUL PICCINNINI SR. MA, LCAT, CMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	221700000X	Art Therapist
2	225600000X	Dance Therapist
3	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1033652375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH PAUL PICCINNINI SR. MA, LCAT, CMT

Provider Business Mailing Address
First Line	:	25 PAGE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309
Country	:	US
Telephone Number	:	718-967-4686
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 PAGE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-2611
Country	:	US
Telephone Number	:	718-967-4686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2016
Last Update Date	:	11/18/2016

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