Healthcare Provider Details

I. General information

NPI: 1295362200
Provider Name (Legal Business Name): ELLIOT LEVIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COLUMBUS AVE STE 200E
VALHALLA NY
10595-1392
US

IV. Provider business mailing address

814 DOWNING ST
TEANECK NJ
07666-2219
US

V. Phone/Fax

Practice location:
  • Phone: 914-614-4343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number329103
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: