Basic Information
| Provider Information | |||||||||
| NPI: | 1861581191 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVITON | ||||||||
| FirstName: | IRA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 EAST 210TH STREET | ||||||||
| Address2: | MONTEFIORE HOSPITAL | ||||||||
| City: | THE BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189207791 | ||||||||
| FaxNumber: | 7189202746 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 EAST 210TH STREET | ||||||||
| Address2: | MONTEFIORE HOSPITAL | ||||||||
| City: | THE BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189207791 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 08/24/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 164764 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.