Basic Information
| Provider Information | |||||||||
| NPI: | 1649683079 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEVY | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | DAWN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1307 FEDERAL ST STE 304 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123593682 | ||||||||
| FaxNumber: | 4123598541 | ||||||||
| Practice Location | |||||||||
| Address1: | 1307 FEDERAL ST STE 304 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123593682 | ||||||||
| FaxNumber: | 4123598541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2014 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 01/07/2015 | ||||||||
| NPIReactivationDate: | 04/20/2015 | ||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD461525 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 103253208 | 05 | PA | MEDICAID |