Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 350446 | NY |
NPI | 1134600505 |
---|---|
Provider Name | Mrs. Bobbi-Jo Rose Levine |
First Address | Oceanside, NY 11572-5721 |
Second Address | New Hyde Park, NY 11040-1433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 23/08/2018 |