Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | C7-0003823 | DE |
N | 208000000X | Pediatrician | MT 190803 | PA |
N | 208D00000X | General Practice Physician | MD439351 | PA |
NPI | 1013110980 |
---|---|
Provider Name | Dr. Carly D. Levy |
First Address | Rockland, DE 19803 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 31/08/2011 |