MEDICARE: CARLY CAPRIOLI MS, 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	11739	NY
2	225A00000X	Music Therapist	002171	NY

General Provider Information

NPI Number	:	1669254512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY CAPRIOLI MS, LCAT, MT-BC

Provider Business Mailing Address
First Line	:	25 W BROADWAY APT 514
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4033
Country	:	US
Telephone Number	:	516-578-9842
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 W BROADWAY APT 514
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4033
Country	:	US
Telephone Number	:	516-578-9842
Fax Number	:

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

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	10/16/2023

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