Provider Demographics
NPI:1972377695
Name:INNA LEVTSENKO NURSE PRACTITIONER IN ADULT HEALTH PC
Entity type:Organization
Organization Name:INNA LEVTSENKO NURSE PRACTITIONER IN ADULT HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVTSENKO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:917-627-3670
Mailing Address - Street 1:415 E 85TH ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6356
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8106 BAXTER AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1385
Practice Address - Country:US
Practice Address - Phone:917-627-3670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty