Provider Demographics
NPI:1356429518
Name:LEVY, PAUL A (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3415 BAINBRIDGE AVE
Mailing Address - Street 2:PEDIATRIC GENETICS
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2403
Mailing Address - Country:US
Mailing Address - Phone:718-741-2323
Mailing Address - Fax:718-920-6506
Practice Address - Street 1:CHAM
Practice Address - Street 2:3415 BAINBRIDGE AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-741-2323
Practice Address - Fax:718-920-6506
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY178748208000000X, 207SG0201X, 207SG0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)