MEDICARE: MS. DE'VORAH B LEVI REGISTERED NURSE

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	163WL0100X	Lactation Consultant (Registered Nurse)	455458	NY
2	374J00000X	Doula		NY
3	163W00000X	Registered Nurse	455458	NY

General Provider Information

NPI Number	:	1801694211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DE'VORAH B LEVI REGISTERED NURSE

Provider Business Mailing Address
First Line	:	1425 ALBANY AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-6504
Country	:	US
Telephone Number	:	347-466-8279
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 ALBANY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-6504
Country	:	US
Telephone Number	:	347-466-8279
Fax Number	:

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

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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