Provider Demographics
NPI:1205156254
Name:LEVY, DAVID (NP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 HOUMA BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2932
Mailing Address - Country:US
Mailing Address - Phone:504-883-3700
Mailing Address - Fax:504-883-3710
Practice Address - Street 1:3800 HOUMA BLVD
Practice Address - Street 2:STE 325
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4182
Practice Address - Country:US
Practice Address - Phone:504-888-7111
Practice Address - Fax:504-888-6655
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN107034163WG0000X
LARN107034-AP06164363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2127241Medicaid
LA50617Medicare PIN