MEDICARE: MARIA LEVENTIS NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F401819-1	NY

General Provider Information

NPI Number	:	1902261191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA LEVENTIS NP

Provider Business Mailing Address
First Line	:	347 E 78TH ST APT 1C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1332
Country	:	US
Telephone Number	:	917-450-0534
Fax Number	:

Provider Business Practice Location Address
First Line	:	347 E 78TH ST APT 1C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1332
Country	:	US
Telephone Number	:	917-450-0534
Fax Number	:

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

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	12/15/2015

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