Basic Information
| Provider Information | |||||||||
| NPI: | 1205815131 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVAT | ||||||||
| FirstName: | JAY | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 WESTCHESTER AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146813146 | ||||||||
| FaxNumber: | 9146826403 | ||||||||
| Practice Location | |||||||||
| Address1: | 3020 WESTCHESTER AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | PURCHASE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105772510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142536464 | ||||||||
| FaxNumber: | 9146826403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 10/16/2013 | ||||||||
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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 | 207R00000X | 155530 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 037457 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 133884168 | 01 | NY | BEECH STREET | OTHER | 4247752 | 01 | NY | AETNA NON HMO | OTHER | 133884168 | 01 | NY | EMPIRE STATE PLAN (NYS) | OTHER | 0926065-011 | 01 | NY | CIGNA PCP | OTHER | 43D941/43D942 | 01 | NY | BLUE CROSS HMO/SENIOR | OTHER |