Healthcare Provider Details

I. General information

NPI: 1467547869
Provider Name (Legal Business Name): DAVID A LEVITSKY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 WESTBURY AVE
PLAINVIEW NY
11803-3611
US

IV. Provider business mailing address

99 WESTBURY AVE
PLAINVIEW NY
11803-3611
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-9666
  • Fax:
Mailing address:
  • Phone: 516-822-9666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN 2709
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0054811
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerGHI ID NUMBER
# 2
IdentifierP30433
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerEMPIREBLUE PROVIDER #
# 3
Identifier00401529
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: