Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 205801 | NY |
NPI | 1821157751 |
---|---|
Provider Name | Dr. Jennifer M Levine |
First Address | New York, NY 10075-1257 |
Second Address | New York, NY 10075-1257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 19/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H81682 | (02) | NY |