Provider Demographics
NPI:1962137745
Name:LEVY, DIZZA JOY (RPH)
Entity type:Individual
Prefix:
First Name:DIZZA
Middle Name:JOY
Last Name:LEVY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 POPLAR CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1424
Mailing Address - Country:US
Mailing Address - Phone:410-370-2219
Mailing Address - Fax:
Practice Address - Street 1:5309 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-5109
Practice Address - Country:US
Practice Address - Phone:410-601-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist