Provider Demographics
NPI:1962657924
Name:LEVY, CARA S (CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:S
Last Name:LEVY
Suffix:
Gender:F
Credentials:CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CARLING DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3721
Mailing Address - Country:US
Mailing Address - Phone:516-294-0275
Mailing Address - Fax:516-294-3763
Practice Address - Street 1:24 CARLING DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3721
Practice Address - Country:US
Practice Address - Phone:516-294-0275
Practice Address - Fax:516-294-3763
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2034235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist