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General NPI Number Information
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NPI Number | 1215261912
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Entity Type | Individual
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Provider Name | LEIGHTON WHYTE
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Gender | Male
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 14310 SPRINGFIELD BLVD
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City | SPRINGFIELD GARDENS
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State | NY
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Zip | 11413-3240
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Country | US
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Telephone | 718-949-8405
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Fax |
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Provider Business Mailing Address
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Address Line | 24519 149TH RD
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City | ROSEDALE
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State | NY
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Zip | 11422-2717
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Country | US
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Telephone | 516-382-6825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P72324
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 080291
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License Number State | NY
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