Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 25MA10398300 | NJ |
NPI | 1316382641 |
---|---|
Provider Name | Dr. Nikolay Levintov |
First Address | Howell, NJ 07731-2168 |
Second Address | Howell, NJ 07731-2168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2013 |
Last Update Date | 04/01/2022 |