Healthcare Provider Details

I. General information

NPI: 1356329601
Provider Name (Legal Business Name): JOSEPH LEVY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 32ND ST L-3 MEDICAL SUITE
NEW YORK NY
10016-6004
US

IV. Provider business mailing address

160 E 32ND ST L-3 MEDICAL SUITE
NEW YORK NY
10016-6004
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5407
  • Fax: 212-263-5417
Mailing address:
  • Phone: 212-263-5407
  • Fax: 212-263-5417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number141185
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: