MEDICARE: MS. LEVI BALILI LAGAPA PT

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	225100000X	Physical Therapist	054188	NY

General Provider Information

NPI Number	:	1720971740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEVI BALILI LAGAPA PT

Provider Business Mailing Address
First Line	:	8915 BERGENWOOD AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5349
Country	:	US
Telephone Number	:	347-658-6726
Fax Number	:

Provider Business Practice Location Address
First Line	:	8915 BERGENWOOD AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5349
Country	:	US
Telephone Number	:	347-658-6726
Fax Number	:

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

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	05/30/2025

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