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General NPI Number Information
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NPI Number | 1023077393
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Entity Type | Individual
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Provider Name | KIRK JAY LEVY MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 25 ROCKWOOD PL SUITE 110
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-4957
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Country | US
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Telephone | 201-894-5805
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Fax | 201-894-1956
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Provider Business Mailing Address
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Address Line | 25 ROCKWOOD PL SUITE 110
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-4957
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Country | US
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Telephone | 201-894-5805
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Fax | 201-894-1956
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MA69166
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2161951
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License Number State | NY
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