Provider Demographics
NPI:1881919470
Name:LEVY, DAVID ROY (RN,APN-BC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ROY
Last Name:LEVY
Suffix:
Gender:M
Credentials:RN,APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 SAINT JAMES AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1827
Mailing Address - Country:US
Mailing Address - Phone:631-786-7091
Mailing Address - Fax:
Practice Address - Street 1:262 SAINT JAMES AVE N
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1827
Practice Address - Country:US
Practice Address - Phone:631-786-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF30305162363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health