Leviathan Wellness PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LEVIATHAN WELLNESS PLLC

Practice address

55 E Old Country Rd
Hicksville, NY 11801-4293

Phone

(516) 987-6428

NPI assigned

Sep 23, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leila Wilson

Title

Manager

Phone

(917) 612-7485

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1215650379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1584 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283433",
            "telephone_number": "718-621-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E OLD COUNTRY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014293",
            "telephone_number": "516-987-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVIATHAN WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LEILA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-612-7485"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Leon, LMHC
• Debra Leonardo, LCSW-R
• Kristina M Leone
• Theresa Leroy, RN
• Michael Levenson, LMT
• Allison Levin
• Jerold Levinbook, D.M.D.
• Bonnie Sue Levine, S.W. CLINICAL LCSW
• Irina Levy
• Gabrielle Lewis

• Ambulatory Surgical Clinic/Center in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.