Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 9872 | NH |
NPI | 1114012234 |
---|---|
Provider Name | Daniel L Levin |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0RE4279 | (05) | VT |
30010007 | (05) | NH |
C18353 | (02) |