IndividualActive
Jack Levy, MD
NPI 1720512049 · MOHS-Micrographic Surgery Physician · New York, NY
Provider details
- NPI number
- 1720512049
- Entity type
- Individual
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 309233-01 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Practice location
12 West 21st Street
6th Floor
New York, NY 10010
Phone: (212) 343-2222
Approximate (ZIP-level) locationGet directions
Mailing address
19-07 Radburn Rd
Fair Lawn, NJ 07410-4554
Registry dates
- Enumerated
- 2017-04-13
- Last updated
- 2022-10-27
- Certified
- 2022-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.