Healthcare Provider Details

I. General information

NPI: 1710840335
Provider Name (Legal Business Name): LARISA LITAL LEV-ARY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 BROADWAY STE 303
NEW YORK NY
10010-8266
US

IV. Provider business mailing address

1133 BROADWAY STE 303
NEW YORK NY
10010-8266
US

V. Phone/Fax

Practice location:
  • Phone: 646-926-7202
  • Fax:
Mailing address:
  • Phone: 646-926-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberNA
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: