Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 239456 | NY |
NPI | 1013964469 |
---|---|
Provider Name | Dr. Jonathan Philip Levine |
First Address | Bronx, NY 10463-2247 |
Second Address | Bronx, NY 10467-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/07/2007 |