Healthcare Provider Details

I. General information

NPI: 1700030145
Provider Name (Legal Business Name): MR. ALAN DAVID LEVY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 ALBEMARLE RD
BROOKLYN NY
11218-2307
US

IV. Provider business mailing address

213 ALBEMARLE RD
BROOKLYN NY
11218-2307
US

V. Phone/Fax

Practice location:
  • Phone: 917-771-9063
  • Fax:
Mailing address:
  • Phone: 917-771-9063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number007981
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: