Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 257965 | NY |
N | 207PP0204X | Pediatric Emergency Physician | 257965 | NY |
N | 207Q00000X | Family Doctor | 257965 | NY |
NPI | 1346310216 |
---|---|
Provider Name | Nadine R Levick |
First Address | Brooklyn, NY 11212-3139 |
Second Address | Brooklyn, NY 11212-3139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G46271 | (02) | NY |