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Organization
DOCTORS OF NORTHPORT PRIMARY MEDICAL CARE, P.C.
Active
Organization
DOCTORS OF NORTHPORT PRIMARY MEDICAL CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL LEVA M.D. (DELEGATED OFFICIAL)
(718) 699-9737
Entity
Organization
Contact information
Practice address
9406 59TH AVE, SUITE E9, ELMHURST, NY 11373-5151
(718) 699-9737
(718) 699-4361
Mailing address
PO BOX 1501, COMMACK, NY 11725-0939
(718) 699-9737
(718) 699-4361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
173118
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2098944
AETNA HMO#
NY
01
—
5367752
AETNA PPO GROUP#
NY
01
—
CG6264
ELMHURST RR MCR GROUP#
NY
01
—
CG6265
RR MEDICARE NORTHPORT GRP
NY
Enumeration date
11/09/2006
Last updated
10/26/2009
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