Provider Demographics
NPI:1164065405
Name:LEVITT, BRYNA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BRYNA
Middle Name:
Last Name:LEVITT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7534 150TH ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3147
Mailing Address - Country:US
Mailing Address - Phone:917-974-6588
Mailing Address - Fax:
Practice Address - Street 1:7534 150TH ST APT 2D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3147
Practice Address - Country:US
Practice Address - Phone:917-974-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024017225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist