Healthcare Provider Details

I. General information

NPI: 1851974547
Provider Name (Legal Business Name): KATE LEVY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 PROSPECT ST
RIDGEWOOD NJ
07450-4451
US

IV. Provider business mailing address

85 HIGH ST
PASSAIC NJ
07055-4751
US

V. Phone/Fax

Practice location:
  • Phone: 201-639-3900
  • Fax:
Mailing address:
  • Phone: 917-587-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number26NR13566200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ01196700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: