MEDICARE: JAY RICHARD LEVY DPM

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	213E00000X	Podiatrist	N0023131	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	C32925B	OTHER	FIRST UNITED AMERICAN LIF
3	P3026	OTHER	EMPIRE BC

General Provider Information

NPI Number	:	1376646331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY RICHARD LEVY DPM

Provider Business Mailing Address
First Line	:	120 E WASHINGTON ST STE 308
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13202-4007
Country	:	US
Telephone Number	:	315-422-0453
Fax Number	:	315-638-2034

Provider Business Practice Location Address
First Line	:	120 E WASHINGTON ST
Second Line	:	STE 308
City	:	SYRACUSE
State	:	NY
Zip	:	13202-4007
Country	:	US
Telephone Number	:	315-422-0453
Fax Number	:	315-638-2034

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	05/05/2008

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Directions to “ JAY RICHARD LEVY DPM” Practice Location

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