Healthcare Provider Details

I. General information

NPI: 1689193955
Provider Name (Legal Business Name): SVETLANA LEVAK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. SVETLANA ZILBERMAN

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

IV. Provider business mailing address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-8021
  • Fax:
Mailing address:
  • Phone: 718-470-8021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number021900-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number021900-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number021900-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: