Provider Demographics
NPI:1801807979
Name:SHIKHMAN, LEV (PT)
Entity type:Individual
Prefix:MR
First Name:LEV
Middle Name:
Last Name:SHIKHMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3758
Mailing Address - Country:US
Mailing Address - Phone:212-317-1600
Mailing Address - Fax:212-317-9855
Practice Address - Street 1:333 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3758
Practice Address - Country:US
Practice Address - Phone:212-317-1600
Practice Address - Fax:212-317-9855
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021852-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ9901Medicare ID - Type Unspecified