Provider Demographics
NPI:1811580038
Name:LEVI, ANTHEA VICTORIA (RD)
Entity Type:Individual
Prefix:
First Name:ANTHEA
Middle Name:VICTORIA
Last Name:LEVI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 19TH ST APT 8F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4053
Mailing Address - Country:US
Mailing Address - Phone:646-704-2696
Mailing Address - Fax:
Practice Address - Street 1:99 MADISON AVE STE 505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7419
Practice Address - Country:US
Practice Address - Phone:646-704-2696
Practice Address - Fax:833-681-0879
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered