Provider Demographics
NPI:1548487150
Name:LEVY, RICK ALBERT (DPT)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:ALBERT
Last Name:LEVY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1689 GLENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2828
Mailing Address - Country:US
Mailing Address - Phone:718-344-9751
Mailing Address - Fax:
Practice Address - Street 1:355 TROY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-5320
Practice Address - Country:US
Practice Address - Phone:718-774-6144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ15P210Medicare ID - Type Unspecified
NYQ15P210Medicare PIN