Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 246576 | NY |
NPI | 1003912999 |
---|---|
Provider Name | Bernard Levin |
First Address | New York, NY 10025-5005 |
Second Address | New York, NY 10025-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 27/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36672601 | (05) | SD |
C18352 | (02) |