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General NPI Number Information
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NPI Number | 1508264359
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Entity Type | Organization
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Legal Business Name | DR. ANDREW B. LEVY, DDS, P.C.
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 77 E. 12TH ST PS1
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-674-2024
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Fax |
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Provider Business Mailing Address
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Address Line | 77 E. 12TH ST PS1
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-674-2024
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Fax | 212-674-2023
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | MR. ANDREW BRYAN LEVY
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Credential | D.D.S.
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Telephone | 212-674-2024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 056210
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License Number State | NY
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