Provider Demographics
NPI:1619288271
Name:LEVY, CHAIM (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WILDER RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1027
Mailing Address - Country:US
Mailing Address - Phone:845-354-8776
Mailing Address - Fax:
Practice Address - Street 1:42 WILDER RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1027
Practice Address - Country:US
Practice Address - Phone:845-354-8776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038727122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist