Provider Demographics
NPI:1245536911
Name:LEVY, JONATHAN MARC (DPM)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MARC
Last Name:LEVY
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:120 E 56TH ST
Mailing Address - Street 2:SUITE 940
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3607
Mailing Address - Country:US
Mailing Address - Phone:212-940-6487
Mailing Address - Fax:212-980-8685
Practice Address - Street 1:120 E 56TH ST
Practice Address - Street 2:SUITE 940
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3607
Practice Address - Country:US
Practice Address - Phone:212-940-6487
Practice Address - Fax:212-980-8685
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2013-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00312500213ES0103X
NY006564213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery