Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 037666-1 | NY |
NPI | 1144374372 |
---|---|
Provider Name | Dr. Philip Levis |
First Address | Eastchester, NY 10709-4407 |
Second Address | Eastchester, NY 10709-4407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |