Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 2161951 | NY |
Y | 2084N0400X | Neurologist | MA69166 | NJ |
NPI | 1023077393 |
---|---|
Provider Name | Dr. Kirk Jay Levy |
First Address | Englewood, NJ 07631-4957 |
Second Address | Englewood, NJ 07631-4957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 11/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H13287 | (02) |