MEDICARE: GABRIEL S LEVI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	188765	NY
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25MA10812200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A400062328	OTHER	NY	NGS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205834140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL S LEVI MD

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:
Fax Number	:	770-666-9097

Provider Business Practice Location Address
First Line	:	1 DIAMOND HILL RD FL G
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-277-8699
Fax Number	:	908-673-7388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/03/2023

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Directions to “ GABRIEL S LEVI MD” Practice Location

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