Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MA058268 | NJ |
NPI | 1063453322 |
---|---|
Provider Name | Dr. Sheldon Elliot Levine |
First Address | Mahwah, NJ 07430-3516 |
Second Address | Mahwah, NJ 07430-3516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E20014 | (02) | NJ |