Healthcare Provider Details

I. General information

NPI: 1932551843
Provider Name (Legal Business Name): LEENA THAPA RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 W 108TH ST
NEW YORK NY
10025-2956
US

IV. Provider business mailing address

3545 79TH ST APT 5G
JACKSON HEIGHTS NY
11372-4818
US

V. Phone/Fax

Practice location:
  • Phone: 212-663-3000
  • Fax:
Mailing address:
  • Phone: 646-612-0407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number678327
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF403832-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: