Individual
THERESA LOUISE LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
823 ALLISON DR, RIVER VALE, NJ 07675-6602
(732) 693-9944
Mailing address
510 HEMPSTEAD TPKE RM 203, WEST HEMPSTEAD, NY 11552-1152
(516) 505-7200
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
26NO11393300
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
40446
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
404466
LICENSE
NY
Enumeration date
06/07/2022
Last updated
10/18/2022
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