Provider Demographics
NPI:1013158179
Name:LEVITZ, LILIA (DO)
Entity type:Individual
Prefix:DR
First Name:LILIA
Middle Name:
Last Name:LEVITZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:LILIA
Other - Middle Name:
Other - Last Name:LEVITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:49 WEED AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4922
Mailing Address - Country:US
Mailing Address - Phone:347-351-5866
Mailing Address - Fax:
Practice Address - Street 1:49 WEED AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4922
Practice Address - Country:US
Practice Address - Phone:347-351-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257595-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine