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General NPI Number Information
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NPI Number | 1497950018
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Entity Type | Organization
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Legal Business Name | LEV TAYTS PHYSICIAN PC
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 2542 BOSTON RD STE C
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City | BRONX
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State | NY
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Zip | 10467-9004
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Country | US
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Telephone | 718-324-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 56 MARTHA PL
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City | CHAPPAQUA
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State | NY
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Zip | 10514-3109
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Country | US
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Telephone | 718-324-2700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEV TAYTS
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Credential | M.D.
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Telephone | 718-324-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 208197
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License Number State | NY
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