Provider Demographics
NPI:1184281099
Name:D'ANGELO, DEBORAH JOYCE (LCAT, MT-BC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JOYCE
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:LCAT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 MAIN ST APT A
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-2855
Mailing Address - Country:US
Mailing Address - Phone:516-384-4075
Mailing Address - Fax:
Practice Address - Street 1:1698 ROUTE 9D
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-3535
Practice Address - Country:US
Practice Address - Phone:516-384-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-27
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10191225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist