Healthcare Provider Details

I. General information

NPI: 1386229797
Provider Name (Legal Business Name): EMILY HANNAH LEVKOVICH CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 RICHMOND HILL RD
STATEN ISLAND NY
10314-5904
US

IV. Provider business mailing address

63 DINA CT
STATEN ISLAND NY
10306-1185
US

V. Phone/Fax

Practice location:
  • Phone: 718-979-5678
  • Fax:
Mailing address:
  • Phone: 718-702-9619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: