Healthcare Provider Details

I. General information

NPI: 1508057894
Provider Name (Legal Business Name): STEVEN L LEVY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 MAIN ST S
WOODBURY CT
06798-3407
US

IV. Provider business mailing address

264 MAIN ST S
WOODBURY CT
06798-3407
US

V. Phone/Fax

Practice location:
  • Phone: 203-263-0400
  • Fax: 203-263-0090
Mailing address:
  • Phone: 203-263-0400
  • Fax: 203-263-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number263CT
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: