Provider Demographics
NPI:1346609484
Name:BARD J LEVEY DDS PLLC
Entity Type:Organization
Organization Name:BARD J LEVEY DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-271-6224
Mailing Address - Street 1:1 BALTIC PL
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1606
Mailing Address - Country:US
Mailing Address - Phone:914-271-6224
Mailing Address - Fax:914-271-8384
Practice Address - Street 1:1 BALTIC PL
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-1606
Practice Address - Country:US
Practice Address - Phone:914-271-6224
Practice Address - Fax:914-271-8384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty