Healthcare Provider Details
I. General information
NPI: 1851528434
Provider Name (Legal Business Name): RONALD LEV MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2009
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 W 56TH ST SUITE #4403
NEW YORK NY
10019-3822
US
IV. Provider business mailing address
150 W 56TH ST SUITE #4403
NEW YORK NY
10019-3822
US
V. Phone/Fax
- Phone: 646-752-3584
- Fax:
- Phone: 646-752-3584
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 202K00000X |
| Taxonomy | Phlebology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RONALD
LEV
Title or Position: OWNER
Credential: M.D.
Phone: 646-752-3584