MEDICARE: MS. DANIELLE DELLOIACONO LCAT

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	221700000X	Art Therapist	001482	NY

General Provider Information

NPI Number	:	1205401619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELLE DELLOIACONO LCAT

Provider Business Mailing Address
First Line	:	PO BOX 8708
Second Line	:
City	:	PENACOOK
State	:	NH
Zip	:	03303-8708
Country	:	US
Telephone Number	:	516-633-4838
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 CARTER HILL RD
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03303-4137
Country	:	US
Telephone Number	:	516-633-4838
Fax Number	:

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

Provider Enumeration Date	:	05/26/2021
Last Update Date	:	07/03/2023

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