Provider Demographics
NPI:1649345117
Name:LEVY, PETER H (MPT OCS)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:H
Last Name:LEVY
Suffix:
Gender:M
Credentials:MPT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:516-627-3009
Mailing Address - Fax:516-627-8424
Practice Address - Street 1:1482 NORTHERN BLVD
Practice Address - Street 2:EXCEL RT & SPORTS REHAB
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030
Practice Address - Country:US
Practice Address - Phone:516-627-3009
Practice Address - Fax:516-627-8424
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01004512251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6601339OtherGHI
NY6601339OtherGHI