Provider Demographics
NPI:1619231479
Name:LEVY, DORI (MSED)
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 YORK AVE
Mailing Address - Street 2:APT 32C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4035
Mailing Address - Country:US
Mailing Address - Phone:917-796-3518
Mailing Address - Fax:
Practice Address - Street 1:1365 YORK AVE
Practice Address - Street 2:APT 32C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4035
Practice Address - Country:US
Practice Address - Phone:917-796-3518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist