Provider Demographics
NPI:1487833554
Name:ADVANCED WOMEN'S OBGYN HEALTH CARE OF L.I. P.C.
Entity Type:Organization
Organization Name:ADVANCED WOMEN'S OBGYN HEALTH CARE OF L.I. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEVADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-825-1885
Mailing Address - Street 1:20 W LINCOLN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5730
Mailing Address - Country:US
Mailing Address - Phone:516-825-1885
Mailing Address - Fax:516-568-0356
Practice Address - Street 1:20 W LINCOLN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5730
Practice Address - Country:US
Practice Address - Phone:516-825-1885
Practice Address - Fax:516-568-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125595207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEQ931Medicare PIN