MEDICARE: MISS HAYLEY MICHAEL LEVENSON MS, CCC-SLP

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	235Z00000X	Speech-Language Pathologist	12127556	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12127556	OTHER	NY	ASHA MEMBER

General Provider Information

NPI Number	:	1871692525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS HAYLEY MICHAEL LEVENSON MS, CCC-SLP

Provider Business Mailing Address
First Line	:	7 STUYVESANT OVAL APT 11D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10009-1903
Country	:	US
Telephone Number	:	732-616-2990
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 1ST AVE
Second Line	:	ROOM 111
City	:	NEW YORK
State	:	NY
Zip	:	10010-4004
Country	:	US
Telephone Number	:	212-802-1530
Fax Number	:

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/18/2017

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