Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | CT000111 | CT |
NPI | 1063456499 |
---|---|
Provider Name | Dr. Norman B. Levine |
First Address | Westport, CT 06880-3749 |
Second Address | Westport, CT 06880-3749 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 24/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004130663 | (05) | CT |
U01260 | (02) | CT |