Healthcare Provider Details

I. General information

NPI: 1598685935
Provider Name (Legal Business Name): LEV NATOVICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 PINES TER
FRANKLIN LAKES NJ
07417-1316
US

IV. Provider business mailing address

966 PINES TER
FRANKLIN LAKES NJ
07417-1316
US

V. Phone/Fax

Practice location:
  • Phone: 260-897-1613
  • Fax:
Mailing address:
  • Phone: 260-897-1613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number196845
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number196845
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: