Individual
GINNY OLAZABAL LEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 LAUREL ROAD, NORTHPORT, NY 11768
(631) 261-0158
(631) 261-0296
Mailing address
PO BOX 1501, COMMACK, NY 11725
(631) 261-0158
(631) 261-0296
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
173243
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01068515
—
NY
01
—
173243
HIP
NY
01
—
2111440
AETNA HMO
NY
01
—
3C0048
HEALTHNET
NY
01
—
4109440
AETNA PPO
NY
01
—
54N551
EMPIRE BC BS OF NY
NY
01
—
54N552
EMPIRE BC BS OF NY
NY
01
—
P1131540
OXFORD
NY
Enumeration date
06/20/2006
Last updated
01/15/2008
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