Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00148400 | NJ |
NPI | 1386614204 |
---|---|
Provider Name | Dr. Gary S Levat |
First Address | Newton, NJ 07860-2812 |
Second Address | Newton, NJ 07860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 25/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T44907 | (02) | NJ |