Provider Demographics
NPI:1588703193
Name:LEVANDUSKY, RONALD STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:STEVEN
Last Name:LEVANDUSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 5TH AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8856
Mailing Address - Country:US
Mailing Address - Phone:212-889-6999
Mailing Address - Fax:212-473-7856
Practice Address - Street 1:2 5TH AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8856
Practice Address - Country:US
Practice Address - Phone:212-889-6999
Practice Address - Fax:212-473-7856
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY111867-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00331700Medicaid
NY00331700Medicaid
NYC08921Medicare UPIN