Provider Demographics
NPI:1861429938
Name:LEVESQUE, DAVID SCOTT (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:LEVESQUE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2905
Mailing Address - Country:US
Mailing Address - Phone:201-722-2929
Mailing Address - Fax:201-722-1370
Practice Address - Street 1:124 3RD AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2905
Practice Address - Country:US
Practice Address - Phone:201-722-2929
Practice Address - Fax:201-722-1370
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001195213ES0000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Not Answered213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP5801OtherHEALTH INSURANCE
NJMD00199OtherHEALTH INSURANCE
NJ1477995OtherHEALTH INSURANCE
NJF15661OtherHEALTH INSURANCE
NJ123544OtherHEALTH INSURANCE
NJ6299865OtherHEALTH INSURANCE
NJP666229OtherHEALTH INSURANCE
NJU16632Medicare UPIN
NJMD00199OtherHEALTH INSURANCE