Provider Demographics
NPI:1467639831
Name:LEVY, GILLIAN HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:HELEN
Last Name:LEVY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:24 STEVENS ST
Mailing Address - Street 2:NORWALK HOSPITAL - 5TH FLOOR LABORATORY
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3852
Mailing Address - Country:US
Mailing Address - Phone:203-852-2649
Mailing Address - Fax:203-899-1518
Practice Address - Street 1:24 STEVENS ST
Practice Address - Street 2:NORWALK HOSPITAL - 5TH FLOOR LABORATORY
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3852
Practice Address - Country:US
Practice Address - Phone:203-852-2649
Practice Address - Fax:203-899-1518
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY254980-1207ZP0102X
CT049074207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008054793Medicaid
CTD400167494Medicare PIN