Provider Demographics
NPI:1285694166
Name:LEVY, FIONA HOWARD (MD)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:HOWARD
Last Name:LEVY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 W 89TH ST APT 14C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1967
Mailing Address - Country:US
Mailing Address - Phone:214-952-2851
Mailing Address - Fax:
Practice Address - Street 1:189 W 89TH ST APT 14C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1967
Practice Address - Country:US
Practice Address - Phone:214-952-2851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM04702080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060274002Medicaid
TX8P2328Medicare ID - Type Unspecified
TX060274002Medicaid