Provider Demographics
NPI:1699938001
Name:LEVY, ELLYN BETH (MS)
Entity type:Individual
Prefix:MS
First Name:ELLYN
Middle Name:BETH
Last Name:LEVY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELLYN
Other - Middle Name:
Other - Last Name:FEIERSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:430 E 56TH ST
Mailing Address - Street 2:APT 3 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4171
Mailing Address - Country:US
Mailing Address - Phone:516-398-1467
Mailing Address - Fax:
Practice Address - Street 1:430 EAST 56 STREET
Practice Address - Street 2:APT 3 B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:516-398-1467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0033661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist