Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 056729 | NY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | DS043250 | PA |
NPI | 1215203104 |
---|---|
Provider Name | Dr. Lauren Elizabeth Levi |
First Address | New York, NY 10111-0100 |
Second Address | New York, NY 10111-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 05/08/2021 |