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General NPI Number Information
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NPI Number | 1972377695
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Entity Type | Organization
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Legal Business Name | INNA LEVTSENKO NURSE PRACTITIONER IN ADULT HEALTH PC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 8106 BAXTER AVE
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City | ELMHURST
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State | NY
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Zip | 11373-1385
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Country | US
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Telephone | 917-627-3670
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Fax |
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Provider Business Mailing Address
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Address Line | 415 E 85TH ST APT 5C
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City | NEW YORK
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State | NY
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Zip | 10028-6356
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | INNA LEVTSENKO
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Credential | NP
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Telephone | 917-627-3670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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