Provider Demographics
NPI:1962628362
Name:LEVITZ, JUDY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:ANN
Last Name:LEVITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JUDY
Other - Middle Name:ANN
Other - Last Name:LEVITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, NCPSYA
Mailing Address - Street 1:80 5TH AVE
Mailing Address - Street 2:SUITE 903A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8002
Mailing Address - Country:US
Mailing Address - Phone:212-741-1085
Mailing Address - Fax:212-675-4386
Practice Address - Street 1:80 5TH AVE
Practice Address - Street 2:SUITE 903A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8002
Practice Address - Country:US
Practice Address - Phone:212-741-1085
Practice Address - Fax:212-675-4386
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006678103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist