Individual provider Active NPI

Katina Leo

  • Specialist
  • Syosset, NY
National Provider Identifier
1831510205
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
648040121 Issued in NY
Practice address
47 Humphrey Dr
Syosset, NY 11791-4022
Phone
(516) 921-7171
NPI assigned
Jan 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 648040121 NY Primary

Addresses

Primary practice location

47 Humphrey Dr
Syosset, NY 11791-4022

Mailing address

56 Fox PL
Hicksville, NY 11801-5757
Phone (516) 330-6182

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
648040121NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1831510205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FOX PL",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015757",
            "telephone_number": "516-330-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 HUMPHREY DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914022",
            "telephone_number": "516-921-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "KATINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "648040121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.