MEDICARE: MR. AMERICO JOSEPH LEVA 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	010106-1	NY

General Provider Information

NPI Number	:	1942277546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AMERICO JOSEPH LEVA PT

Provider Business Mailing Address
First Line	:	7 CLOVERLEAF DR
Second Line	:
City	:	BALLSTON LAKE
State	:	NY
Zip	:	12019-9742
Country	:	US
Telephone Number	:	518-399-8242
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 EXECUTIVE PARK DR
Second Line	:	C/O ALBANY PHYSICAL THERAPY
City	:	ALBANY
State	:	NY
Zip	:	12203-3718
Country	:	US
Telephone Number	:	518-489-2449
Fax Number	:	518-489-2991

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	07/08/2007

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