Provider Demographics
NPI:1326092115
Name:LEVEY, STEPHANIE B (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:B
Last Name:LEVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HARDING PL
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1803
Mailing Address - Country:US
Mailing Address - Phone:973-422-0669
Mailing Address - Fax:
Practice Address - Street 1:16 POCONO RD
Practice Address - Street 2:SUITE 301
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2901
Practice Address - Country:US
Practice Address - Phone:973-625-7970
Practice Address - Fax:973-625-9650
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0422600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ134254OtherAMERIHEALTH PPO
NJP2068145OtherOXFORD HEALTH PLANS
NJ3231857OtherAETNA/US HEALTHCARE
NJ60003865OtherHORIZON NEW JERSEY HEALTH
NJ3231857OtherAETNA/US HEALTHCARE
NJLE134254Medicare ID - Type Unspecified