Provider Demographics
NPI:1154417111
Name:LEVY, DENISE ANTOINETTE (DPM)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANTOINETTE
Last Name:LEVY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 E MOSHOLU PKWY S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1174
Mailing Address - Country:US
Mailing Address - Phone:718-824-0183
Mailing Address - Fax:718-239-8112
Practice Address - Street 1:176 E MOSHOLU PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1174
Practice Address - Country:US
Practice Address - Phone:718-824-0183
Practice Address - Fax:718-239-8112
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0059131213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
N0059131OtherLICENSE
NY02338663Medicaid
3826432OtherAETNA HMO
6265907OtherBCBS HMO PPO
421592OtherGUARDIAN
7179688OtherAETNA TRADITIONAL
476170OtherPHCS
8344176OtherCIGNA
P2956205OtherOXFORD
BL8113677OtherDEA
U93668Medicare UPIN
NY02338663Medicaid