Individual
NICHOLAS JOHN DEFEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, MT-BC
Contact information
Practice address
6 MADISON ST, PORT WASHINGTON, NY 11050-3208
(516) 695-2346
Mailing address
6 MADISON ST, PORT WASHINGTON, NY 11050-3208
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
MT-BC
NY
Other
Enumeration date
10/08/2017
Last updated
10/08/2017
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