Provider Demographics
NPI:1275994386
Name:LEVY, ELIZABETH (MS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E 83RD ST
Mailing Address - Street 2:APT 9G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4318
Mailing Address - Country:US
Mailing Address - Phone:513-515-5441
Mailing Address - Fax:
Practice Address - Street 1:303 E 83RD ST
Practice Address - Street 2:APT 9G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4318
Practice Address - Country:US
Practice Address - Phone:513-515-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY993289151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist