Provider Demographics
NPI:1750766291
Name:VELILLA, LESLEYANN (NP)
Entity type:Individual
Prefix:
First Name:LESLEYANN
Middle Name:
Last Name:VELILLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 NORTHERN BLVD
Mailing Address - Street 2:NEW YORK FOUNDLING HOSPITAL
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2221
Mailing Address - Country:US
Mailing Address - Phone:917-485-7564
Mailing Address - Fax:718-551-3580
Practice Address - Street 1:3300 NORTHERN BLVD
Practice Address - Street 2:NEW YORK FOUNDLING HOSPITAL
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2221
Practice Address - Country:US
Practice Address - Phone:917-485-7564
Practice Address - Fax:718-551-3580
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF382545363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics