Provider Demographics
NPI:1841274834
Name:LEVY, DANIEL E (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1502
Mailing Address - Country:US
Mailing Address - Phone:516-561-7500
Mailing Address - Fax:516-561-7515
Practice Address - Street 1:788 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1502
Practice Address - Country:US
Practice Address - Phone:516-561-7500
Practice Address - Fax:516-561-7515
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184268-1207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01610984Medicaid
NY44J592Medicare ID - Type Unspecified
NY01610984Medicaid