Healthcare Provider Details

I. General information

NPI: 1801694211
Provider Name (Legal Business Name): DE'VORAH B LEVI REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 ALBANY AVE
BROOKLYN NY
11203-6504
US

IV. Provider business mailing address

1425 ALBANY AVE APT 1
BROOKLYN NY
11203-6504
US

V. Phone/Fax

Practice location:
  • Phone: 347-466-8279
  • Fax:
Mailing address:
  • Phone: 347-466-8279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number455458
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number455458
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: