1508057894 NPI number — DR. STEVEN L LEVY D.C.

Table of content: DR. STEVEN L LEVY D.C. (NPI 1508057894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508057894 NPI number — DR. STEVEN L LEVY D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVY
Provider First Name:
STEVEN
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1508057894
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
264 MAIN ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06798-3407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-263-0400
Provider Business Mailing Address Fax Number:
203-263-0090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
264 MAIN ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06798-3407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-263-0400
Provider Business Practice Location Address Fax Number:
203-263-0090
Provider Enumeration Date:
08/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  263CT , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LIS082 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: OV1292 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1008118 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0098151 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 050000263CT02 . This is a "BCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 707182 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 9504897 . This is a "GHI" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".