Individual
MRS. JACQUELINE I LEVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6605 BOOTH ST, REGO PARK, NY 11374-4633
(917) 612-2497
(718) 459-6325
Mailing address
6605 BOOTH ST, REGO PARK, NY 11374-4633
(917) 612-2497
(718) 459-6325
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
460073
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930546695
GHI
NY
Enumeration date
11/05/2010
Last updated
12/14/2010
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