Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 271669 | NY |
NPI | 1932532710 |
---|---|
Provider Name | Annie Levesque |
First Address | Montreal, QUEBEC H2S 2C2 |
Second Address | New York, NY 10019-1147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2013 |
Last Update Date | 15/08/2013 |