Provider Demographics
NPI:1215146683
Name:LEVAN, JUDY KAPLAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:KAPLAN
Last Name:LEVAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SUMMIT TER
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1407
Mailing Address - Country:US
Mailing Address - Phone:917-599-6450
Mailing Address - Fax:
Practice Address - Street 1:547 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-2143
Practice Address - Country:US
Practice Address - Phone:917-599-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015275103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02379362Medicaid
NY02379362Medicaid