Provider Demographics
NPI:1699853168
Name:LEVY, IRWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5102
Mailing Address - Country:US
Mailing Address - Phone:212-477-6300
Mailing Address - Fax:212-780-0179
Practice Address - Street 1:70 E 10TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5102
Practice Address - Country:US
Practice Address - Phone:212-477-6300
Practice Address - Fax:212-780-0179
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0305101223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D5B301Medicare PIN