Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 026435 | CT |
NPI | 1407822489 |
---|---|
Provider Name | Susan R Levy |
First Address | Guilford, CT 06437 |
Second Address | Guilford, CT 06437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 30/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001264357 | (05) | CT |
E31767 | (02) |