Provider Demographics
NPI:1407831126
Name:LEVY, STEVEN A (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:LEVY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1538
Mailing Address - Country:US
Mailing Address - Phone:201-261-7407
Mailing Address - Fax:201-261-7409
Practice Address - Street 1:297 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1538
Practice Address - Country:US
Practice Address - Phone:201-261-7407
Practice Address - Fax:201-261-7409
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00179600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSLOPA00710OtherBC/BS
NJ480024499OtherRR MEDICARE
NJBS236OtherOXFORD
NJ0724740001OtherNHIC/DME
NJ3430804Medicaid
NJJ38990OtherHEALTHNET
NJ0064892OtherGHI
NYA400006902Medicare PIN
NJ542593WOBMedicare PIN
NJU06127Medicare UPIN