Provider Demographics
NPI:1023325156
Name:LEVY, CHRISTINA M
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:LEVY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12341 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:CHAFFEE
Mailing Address - State:NY
Mailing Address - Zip Code:14030-9414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12341 WEST AVE
Practice Address - Street 2:
Practice Address - City:CHAFFEE
Practice Address - State:NY
Practice Address - Zip Code:14030-9414
Practice Address - Country:US
Practice Address - Phone:716-496-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002193-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant