Provider Demographics
NPI:1710118104
Name:LEVINSKAYA, NATALIA (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:LEVINSKAYA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SUNNYSIDE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1517
Mailing Address - Country:US
Mailing Address - Phone:516-506-7776
Mailing Address - Fax:516-719-0708
Practice Address - Street 1:54 SUNNYSIDE BLVD STE E
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1517
Practice Address - Country:US
Practice Address - Phone:516-506-7776
Practice Address - Fax:516-719-0708
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260076207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3554987Medicaid
NY3554987Medicaid