Leighann Aquaviva

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Medford, NY

NPI 1629533112 · NPPES record last updated Feb 8, 2019

Key facts

NPI
1629533112
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
12 Platinum CT
Medford, NY 11763-2247
Phone
(631) 868-3577
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Little Angels Center, Inc Past
since May 1, 2013
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

12 Platinum CT
Medford, NY 11763-2247

Mailing address

235 Blue Point Ave
Blue Point, NY 11715-1261
Phone (631) 363-5794

Other providers in Medford, NY

All providers in Medford, NY · Student in an Organized Health Care Education/Training Program in New York

Sources for this page

Verify at the official NPI Registry.