MEDICARE: DEBORAH JOYCE D'ANGELO LCAT, MT-BC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist	10191	NY

General Provider Information

NPI Number	:	1184281099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH JOYCE D'ANGELO LCAT, MT-BC

Provider Business Mailing Address
First Line	:	156 MAIN ST APT A
Second Line	:
City	:	COLD SPRING
State	:	NY
Zip	:	10516-2855
Country	:	US
Telephone Number	:	516-384-4075
Fax Number	:

Provider Business Practice Location Address
First Line	:	1698 ROUTE 9D
Second Line	:
City	:	COLD SPRING
State	:	NY
Zip	:	10516-3535
Country	:	US
Telephone Number	:	516-384-4075
Fax Number	:

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

Provider Enumeration Date	:	05/27/2019
Last Update Date	:	05/27/2019

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