Provider Demographics
NPI:1881026359
Name:LEVY, ANDREA MICHELLE (MS, MPH, CCC, SP)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:MICHELLE
Last Name:LEVY
Suffix:
Gender:F
Credentials:MS, MPH, CCC, SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S OXFORD ST
Mailing Address - Street 2:7A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4221
Mailing Address - Country:US
Mailing Address - Phone:917-836-2156
Mailing Address - Fax:
Practice Address - Street 1:212 S OXFORD ST
Practice Address - Street 2:7A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4221
Practice Address - Country:US
Practice Address - Phone:917-836-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist