Provider Demographics
NPI:1043532914
Name:ZICCHINOLFI-LEINUNG, ELAINE MARIE (FNP,DNP)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:MARIE
Last Name:ZICCHINOLFI-LEINUNG
Suffix:
Gender:F
Credentials:FNP,DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W 27TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5902
Mailing Address - Country:US
Mailing Address - Phone:212-217-4190
Mailing Address - Fax:212-217-4191
Practice Address - Street 1:227 W 27TH ST
Practice Address - Street 2:ROOM 402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5902
Practice Address - Country:US
Practice Address - Phone:212-217-4190
Practice Address - Fax:212-217-4191
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYML 0524353OtherDEA