Provider Demographics
NPI:1437186939
Name:LEVY, MARC (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5311
Mailing Address - Country:US
Mailing Address - Phone:516-433-1963
Mailing Address - Fax:
Practice Address - Street 1:4228 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3822
Practice Address - Country:US
Practice Address - Phone:718-886-7789
Practice Address - Fax:718-463-3669
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist