Provider Demographics
NPI:1164727137
Name:RONALD A LEVY MD PC
Entity Type:Organization
Organization Name:RONALD A LEVY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:516-482-7965
Mailing Address - Street 1:29 BARSTOW RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2222
Mailing Address - Country:US
Mailing Address - Phone:516-482-7965
Mailing Address - Fax:516-482-4122
Practice Address - Street 1:29 BARSTOW RD
Practice Address - Street 2:SUITE 203
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2222
Practice Address - Country:US
Practice Address - Phone:516-482-7965
Practice Address - Fax:516-482-4122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098399174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
514551Medicare PIN
NYC10792Medicare UPIN