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General NPI Number Information
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NPI Number | 1598614612
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Entity Type | Organization
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Legal Business Name | LEANWELL
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Dates
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Enumeration Date | 01/22/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 337 HAMPTON GRN
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City | STATEN ISLAND
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State | NY
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Zip | 10312-1722
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Country | US
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Telephone | 646-441-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 337 HAMPTON GRN
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City | STATEN ISLAND
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State | NY
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Zip | 10312-1722
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Country | US
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Telephone | 646-441-0626
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Fax |
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Authorized Official
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Title or Position | FNP-BC
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Name | LARA TREGILLIES
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Credential | NP
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Telephone | 646-872-0556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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