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General NPI Number Information
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NPI Number | 1700611779
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Entity Type | Individual
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Provider Name | LEIGH A HANSEN LMT
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Gender | Female
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Dates
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Enumeration Date | 09/07/2024
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Last Update Date | 09/07/2024
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Provider Practice Location Address
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Address Line | 107 W 82ND ST STE 108
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City | NEW YORK
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State | NY
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Zip | 10024-5511
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Country | US
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Telephone | 917-558-0228
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Fax |
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Provider Business Mailing Address
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Address Line | 270 W 124TH ST APT 10D
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City | NEW YORK
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State | NY
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Zip | 10027-5087
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Country | US
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Telephone | 917-951-4467
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 015262
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License Number State | NY
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