Provider Demographics
NPI:1780198580
Name:LEVI, DEANNE D
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:D
Last Name:LEVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 KENSINGTON OVAL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-2905
Mailing Address - Country:US
Mailing Address - Phone:914-310-0056
Mailing Address - Fax:913-834-3166
Practice Address - Street 1:167 KENSINGTON OVAL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-2905
Practice Address - Country:US
Practice Address - Phone:914-310-0056
Practice Address - Fax:913-834-3166
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician