MEDICARE: DR. MAIA YAEL LEVY DDS

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	1223P0221X	Pediatric Dentistry	061912	NY

General Provider Information

NPI Number	:	1487277273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAIA YAEL LEVY DDS

Provider Business Mailing Address
First Line	:	1500 LEXINGTON AVE APT 9G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-7354
Country	:	US
Telephone Number	:	516-417-3284
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 EXECUTIVE BLVD
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-4180
Country	:	US
Telephone Number	:	845-371-0093
Fax Number	:

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

Provider Enumeration Date	:	05/27/2020
Last Update Date	:	09/13/2023

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