Provider Demographics
NPI:1164959870
Name:DR GARY LEVAT LLC
Entity Type:Organization
Organization Name:DR GARY LEVAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-300-2450
Mailing Address - Street 1:125 NEWTON SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2812
Mailing Address - Country:US
Mailing Address - Phone:973-300-2450
Mailing Address - Fax:973-300-2455
Practice Address - Street 1:125 NEWTON SPARTA RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2812
Practice Address - Country:US
Practice Address - Phone:973-300-2450
Practice Address - Fax:973-300-2455
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARY LEVAT,DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01484261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT44907Medicare UPIN