Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 227813 | NY |
NPI | 1245283084 |
---|---|
Provider Name | Dr. Jennifer Levine |
First Address | New York, NY 10032-1559 |
Second Address | New York, NY 10032-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 10/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0105694 | MEDICAID (01) | NJ |
02299934 | (05) | NY |
H60568 | (02) | NY |