# LEVIATHAN WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215650379
- **Authorized official:** LEILA WILSON (MANAGER)
- **Authorized official phone:** (917) 612-7485

## Contact information

- **Practice address:** 55 E OLD COUNTRY RD, HICKSVILLE, NY 11801-4293
- **Practice address phone:** (516) 987-6428
- **Mailing address:** 1584 86TH ST, BROOKLYN, NY 11228-3433
- **Mailing address phone:** (718) 621-5800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/23/2022
- **Last updated:** 09/23/2022