Provider Demographics
NPI:1255821047
Name:DYGERT, LEVI DANIEL (MD)
Entity type:Individual
Prefix:
First Name:LEVI
Middle Name:DANIEL
Last Name:DYGERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:14 WALL ST FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-2178
Mailing Address - Country:US
Mailing Address - Phone:646-501-3224
Mailing Address - Fax:
Practice Address - Street 1:1530 FRONT ST STE 400
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2265
Practice Address - Country:US
Practice Address - Phone:516-324-7500
Practice Address - Fax:929-455-9653
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY3169282084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology