Provider Demographics
NPI:1033719034
Name:LEVY, EMILY JENNIFER I (RN)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:JENNIFER
Last Name:LEVY
Suffix:I
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LONGACRE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3966
Mailing Address - Country:US
Mailing Address - Phone:631-626-8108
Mailing Address - Fax:
Practice Address - Street 1:3085 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-7614
Practice Address - Country:US
Practice Address - Phone:631-854-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY786407-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse