Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 169689 | NY |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 25MA04701600 | NJ |
NPI | 1144402678 |
---|---|
Provider Name | Anne-Marie Levan |
First Address | Midland Park, NJ 07432-1544 |
Second Address | Midland Park, NJ 07432-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2007 |
Last Update Date | 15/06/2011 |