Provider Demographics
NPI:1386155042
Name:LEVTER, VERA (NP)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:LEVTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6333 98TH PL APT 8L
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2322
Mailing Address - Country:US
Mailing Address - Phone:646-496-7290
Mailing Address - Fax:
Practice Address - Street 1:11115 QUEENS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7422
Practice Address - Country:US
Practice Address - Phone:718-520-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF05170238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily