Healthcare Provider Details

I. General information

NPI: 1750455176
Provider Name (Legal Business Name): HOWARD BRETT LEVY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

408 DEGRAW ST
BROOKLYN NY
11231-4713
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-6151
  • Fax:
Mailing address:
  • Phone: 718-246-4775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number087768
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: