Healthcare Provider Details

I. General information

NPI: 1861429938
Provider Name (Legal Business Name): DAVID SCOTT LEVESQUE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 3RD AVE
WESTWOOD NJ
07675-2905
US

IV. Provider business mailing address

124 3RD AVE
WESTWOOD NJ
07675-2905
US

V. Phone/Fax

Practice location:
  • Phone: 201-722-2929
  • Fax: 201-722-1370
Mailing address:
  • Phone: 201-722-2929
  • Fax: 201-722-1370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberMD001195
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberMD001195
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: