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General NPI Number Information
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NPI Number | 1013315050
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Entity Type | Organization
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Legal Business Name | LEVIN VALENCIA PODIATRY PLLC
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 1 MAIDEN LN FL 2
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City | NEW YORK
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State | NY
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Zip | 10038-5132
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Country | US
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Telephone | 212-571-1017
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MAIDEN LN FL 2
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City | NEW YORK
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State | NY
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Zip | 10038-5132
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Country | US
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Telephone | 212-571-1017
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. DIANA LEVIN VALENCIA
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Credential | DPM
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Telephone | 212-571-1017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | N006579-1
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License Number State | NY
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