1841222577 NPI number — PAUL R LEVA MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841222577 NPI number — PAUL R LEVA MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LEVA

Provider First Name:

PAUL

Provider Middle Name:

R

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1841222577

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/17/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

320 LAUREL RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

NORTHPORT

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11768-3138

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

631-261-0158

Provider Business Mailing Address Fax Number:

631-261-0296

Provider First Line Business Practice Location Address:

320 LAUREL RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NORTHPORT

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

11768-3138

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

631-261-0158

Provider Business Practice Location Address Fax Number:

631-261-0296

Provider Enumeration Date:

07/06/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  173118 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000000059073 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 173118 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 5352101 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0088949 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0P4162 . This is a "EMPIRE BCBS OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 2C7927 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: CG6264 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 01065030 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 0462576 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 17E412 . This is a "EMPIRE BCBS OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: CG6265 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: P378023 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".