Individual provider Active NPI

Leyla D Ertegun

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1467787242
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
115 W 73Rd St Apt 1D
New York, NY 10023
Phone
(646) 859-0676
NPI assigned
Oct 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

115 W 73Rd St Apt 1D
New York, NY 10023

Mailing address

115 W 73Rd St Apt 1D
New York, NY 10023-2912
Phone (917) 653-8991

Other practice location 1

177 E 87th St # 409
New York, NY 10128-2226
Phone (917) 653-8991

Other practice location 2

5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138
Phone (718) 796-5300 ext. 104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081739NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1467787242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 73RD ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232912",
            "telephone_number": "917-653-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 73RD ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "646-859-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 E 87th St # 409",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101282226",
            "country_code": "US",
            "telephone_number": "917-653-8991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5676 Riverdale Ave",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104712138",
            "country_code": "US",
            "telephone_number": "718-796-5300 x104",
            "fax_number": "718-548-1161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERTEGUN",
        "first_name": "LEYLA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.