MEDICARE: RICHMOND MUSIC CENTER

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	:	1669722757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND MUSIC CENTER

Provider Business Mailing 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	:

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	:	PRESIDENT
Name	:	JOSEPH PICCINNINI
Credential	:	MA, LCAT,CMT
Telephone Number	:	718-967-4686

Provider Enumeration Date	:	09/15/2012
Last Update Date	:	09/18/2012

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Directions to “RICHMOND MUSIC CENTER ” Practice Location

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