Provider Demographics
NPI:1124204490
Name:YAKOV LEVY MD PC
Entity type:Organization
Organization Name:YAKOV LEVY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YAKOV
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-520-8700
Mailing Address - Street 1:6561 SAUNDERS ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4252
Mailing Address - Country:US
Mailing Address - Phone:718-416-4389
Mailing Address - Fax:718-416-3652
Practice Address - Street 1:70-31A 108TH STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-0000
Practice Address - Country:US
Practice Address - Phone:718-520-8700
Practice Address - Fax:718-520-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226066207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWYQRR1Medicare PIN