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General NPI Number Information
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NPI Number | 1508075938
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Entity Type | Individual
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Provider Name | HELEN LEITL NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | SCO FAMILY OF SERVICES, INFIRMARY PARK AND DOWNING AVENUES
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City | SEA CLIFF
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State | NY
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Zip | 11579
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Country | US
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Telephone | 516-671-1111
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Fax | 516-671-7673
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Provider Business Mailing Address
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Address Line | 29 KELLUM ST
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3867
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Country | US
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Telephone | 516-671-1111
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Fax | 516-671-7673
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F380854
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License Number State | NY
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