Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 242691 | NY |
N | 111NI0900X | Internist | 242691 | NY |
Y | 207RC0000X | Internist - Cardiovascular Disease | 242691 | NY |
NPI | 1003948464 |
---|---|
Provider Name | Dr. Michael Jason Levine |
First Address | New Hyde Park, NY 11042-1220 |
Second Address | New Hyde Park, NY 11042-1220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 12/02/2021 |