Healthcare Provider Details

I. General information

NPI: 1043532914
Provider Name (Legal Business Name): ELAINE MARIE ZICCHINOLFI-LEINUNG FNP,DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2010
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 W 27TH ST ROOM 402
NEW YORK NY
10001-5902
US

IV. Provider business mailing address

227 W 27TH ST
NEW YORK NY
10001-5902
US

V. Phone/Fax

Practice location:
  • Phone: 212-217-4190
  • Fax: 212-217-4191
Mailing address:
  • Phone: 212-217-4190
  • Fax: 212-217-4191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332866
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: