Provider Demographics
NPI:1083247720
Name:CHERISE MIZRAHI-LEVI DO PA
Entity Type:Organization
Organization Name:CHERISE MIZRAHI-LEVI DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZRAHI-LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-733-8652
Mailing Address - Street 1:2140 NE 26TH ST
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1536
Mailing Address - Country:US
Mailing Address - Phone:347-733-8652
Mailing Address - Fax:
Practice Address - Street 1:2140 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1536
Practice Address - Country:US
Practice Address - Phone:347-733-8652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty