Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA08273700 | NJ |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 48895 | TN |
N | 2080P0207X | Pediatric Hematology-Oncologist | D67521 | MD |
NPI | 1124218482 |
---|---|
Provider Name | Dr. Deena Rachel Levine |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 19/11/2020 |