Provider Demographics
NPI:1821062977
Name:VOLPICELLA-LEVY, SUSAN L (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:VOLPICELLA-LEVY
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 1:261 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3102
Mailing Address - Country:US
Mailing Address - Phone:201-666-9600
Mailing Address - Fax:201-666-5014
Practice Address - Street 1:261 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3102
Practice Address - Country:US
Practice Address - Phone:201-666-9600
Practice Address - Fax:201-666-5014
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB052023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0735400Medicaid
NJ0735400Medicaid
NJ608422Medicare ID - Type Unspecified