Provider Demographics
NPI:1508057894
Name:LEVY, STEVEN L (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:LEVY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3407
Mailing Address - Country:US
Mailing Address - Phone:203-263-0400
Mailing Address - Fax:203-263-0090
Practice Address - Street 1:264 MAIN ST S
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3407
Practice Address - Country:US
Practice Address - Phone:203-263-0400
Practice Address - Fax:203-263-0090
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT263CT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTLIS082OtherOXFORD
CTOV1292OtherHEALTHNET
CT1008118OtherCIGNA
CT0098151OtherAETNA
CT050000263CT02OtherBCBS
CT707182OtherCONNECTICARE
CT9504897OtherGHI
CT1008118OtherCIGNA
CT707182OtherCONNECTICARE