Basic Information
Provider Information
NPI: 1013110980
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEVY
FirstName: CARLY
MiddleName: D.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 19803
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Practice Location
Address1: 1600 ROCKLAND ROAD
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198033607
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Other Information
ProviderEnumerationDate: 06/07/2007
LastUpdateDate: 08/31/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XC7-0003823DEY Allopathic & Osteopathic PhysiciansPediatrics 
208000000XMT 190803PAN Allopathic & Osteopathic PhysiciansPediatrics 
208D00000XMD439351PAN Allopathic & Osteopathic PhysiciansGeneral Practice 
208M00000XMD439351PAN Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home