Provider Demographics
NPI:1538426283
Name:LEVY, JAHNNA HOPE (DO)
Entity type:Individual
Prefix:
First Name:JAHNNA
Middle Name:HOPE
Last Name:LEVY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 ROUTE 46 STE 301
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2450
Mailing Address - Country:US
Mailing Address - Phone:973-777-5444
Mailing Address - Fax:973-777-0304
Practice Address - Street 1:1117 ROUTE 46 STE 301
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2450
Practice Address - Country:US
Practice Address - Phone:973-777-5444
Practice Address - Fax:973-777-0304
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MB09927500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program