Individual provider Active NPI

Larry Bruce Levy, RPH

  • Pharmacist
  • Garden City Park, NY
National Provider Identifier
1477721884
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30529 Issued in NY
Practice address
2305 Jericho Tpke
Garden City Park, NY 11040-4709
Phone
(516) 741-1510
Fax
(516) 248-2373
NPI assigned
Feb 19, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30529 NY Primary

Addresses

Primary practice location

2305 Jericho Tpke
Garden City Park, NY 11040-4709

Mailing address

24 Carling Dr
New Hyde Park, NY 11040-3721
Phone (516) 249-0275

Other identifiers 1

IdentifierTypeStateIssuer
30529OtherNYRPH STATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
30529NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathmark Stores Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1477721884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CARLING DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403721",
            "telephone_number": "516-249-0275",
            "fax_number": "516-294-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 JERICHO TPKE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110404709",
            "telephone_number": "516-741-1510",
            "fax_number": "516-248-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "LARRY",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "30529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH STATE LICENSE NUMBER",
            "identifier": "30529",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.