Healthcare Provider Details

I. General information

NPI: 1255235636
Provider Name (Legal Business Name): TZIPORA LIBBY LAST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TZIPORA LEVINE

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 ASTOR PL
MONSEY NY
10952-1013
US

IV. Provider business mailing address

26 ASTOR PL
MONSEY NY
10952-1013
US

V. Phone/Fax

Practice location:
  • Phone: 347-677-4239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number26NR27588600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: