Individual
MICHAEL IRA LEVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1614 N JAMES ST, ROME, NY 13440-2830
(315) 339-7411
Mailing address
610 CYPRESS ST, ROME, NY 13440-2154
(315) 281-4485
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
217243
NY
208000000X
Pediatrics Physician
Primary
217243
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02086602
—
NY
Enumeration date
06/02/2008
Last updated
11/11/2008
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