Provider Demographics
NPI:1932473592
Name:LEVOVITZ, SHOSHANA RAIZEL
Entity type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:RAIZEL
Last Name:LEVOVITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CUMBERLAND PLACE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-5636
Mailing Address - Country:US
Mailing Address - Phone:516-458-1620
Mailing Address - Fax:
Practice Address - Street 1:580 PARK AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1724
Practice Address - Country:US
Practice Address - Phone:516-458-1620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY596689163W00000X
NY336263363LF0000X
NY406492363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily