Healthcare Provider Details

I. General information

NPI: 1972556132
Provider Name (Legal Business Name): JONATHAN M. LEVY, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 56TH ST SUITE 940
NEW YORK NY
10022-3607
US

IV. Provider business mailing address

120 E 56TH ST SUITE 940
NEW YORK NY
10022-3607
US

V. Phone/Fax

Practice location:
  • Phone: 212-980-6487
  • Fax: 212-980-8685
Mailing address:
  • Phone: 212-980-6487
  • Fax: 212-980-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number003732
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number003732
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number003732
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number003732
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number003732
License Number StateNY

VIII. Authorized Official

Name: JONATHAN MARC LEVY
Title or Position: PRESIDENT
Credential: DPM
Phone: 212-980-6487