MEDICARE: MRS. DVORAH LEVY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	076371-1	NY

General Provider Information

NPI Number	:	1326172552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DVORAH LEVY LCSW

Provider Business Mailing Address
First Line	:	1175 W BROADWAY
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-1932
Country	:	US
Telephone Number	:	516-660-7157
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 AVENUE N
Second Line	:	C/O GOLDIE ISAACS
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6105
Country	:	US
Telephone Number	:	718-787-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	05/12/2011

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