Healthcare Provider Details
I. General information
NPI: 1235217332
Provider Name (Legal Business Name): PAUL J LEVY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2545 WALLACE AVENUE
BRONX NY
10467
US
IV. Provider business mailing address
30 ASH DR
ROSLYN NY
11576-2206
US
V. Phone/Fax
- Phone: 718-231-2500
- Fax: 718-231-3159
- Phone: 718-231-2500
- Fax: 718-231-3159
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | N0035811 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | N0035811 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: