Individual
DR. KENNETH A. LEVITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28-04 BROADWAY, GARDEN STATE ORTHOPAEDIC ASSOCIATES, FAIR LAWN, NJ 07410-3913
(201) 791-4434
Mailing address
28-04 BROADWAY, GARDEN STATE ORTHOPAEDIC ASSOCIATES, FAIR LAWN, NJ 07410-3913
(201) 791-4434
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MA05941700
NJ
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
25MA0941700
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25MA05941700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5596408
—
NJ
Enumeration date
03/01/2006
Last updated
07/02/2008
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