Provider Demographics
NPI:1346037207
Name:LEVITSKY, BENJAMIN P
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:P
Last Name:LEVITSKY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LEANN LN
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-7102
Mailing Address - Country:US
Mailing Address - Phone:859-361-9185
Mailing Address - Fax:
Practice Address - Street 1:501 DARBY CREEK RD STE 59
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2611
Practice Address - Country:US
Practice Address - Phone:859-600-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSA370246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant