Provider Demographics
NPI:1457563520
Name:STEVEN A. LEVY, DPM, PC
Entity Type:Organization
Organization Name:STEVEN A. LEVY, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-261-7407
Mailing Address - Street 1:297 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1538
Mailing Address - Country:US
Mailing Address - Phone:201-261-7407
Mailing Address - Fax:201-261-7409
Practice Address - Street 1:297 KINDERKAMACK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1538
Practice Address - Country:US
Practice Address - Phone:201-261-7407
Practice Address - Fax:201-261-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001796213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1407831126OtherNPI
NYA100000760OtherNY MEDICARE PTAN
NJ480024499OtherRR MEDICARE
NJ542593W0BOtherIND PIN
NYA400007052OtherNY MEDICARE PIN
NJ0160890Medicaid
NJDG9621OtherRR MEDICARE GROUP PTAN
NJ1366438442OtherNPI
NYA400006903OtherNY MEDICARE
NJ1366438442OtherNPI
NYA400006903OtherNY MEDICARE
NYA400007052OtherNY MEDICARE PIN
NJ423334W0BMedicare UPIN
NJ114637Medicare PIN
NJ114637Medicare PIN