Provider Demographics
NPI:1821247537
Name:LEVY, URI (DMD)
Entity Type:Individual
Prefix:DR
First Name:URI
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:URI
Other - Middle Name:
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:57 W 57TH ST STE 508
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2802
Mailing Address - Country:US
Mailing Address - Phone:212-751-5448
Mailing Address - Fax:
Practice Address - Street 1:57 W 57TH ST STE 508
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2802
Practice Address - Country:US
Practice Address - Phone:212-751-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0414911122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist