MEDICARE: MR. ERIC JOHN LEVINSON MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	PR013560	NY

General Provider Information

NPI Number	:	1326184466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC JOHN LEVINSON MSW

Provider Business Mailing Address
First Line	:	201 LEDGE DR
Second Line	:
City	:	TORRINGTON
State	:	CT
Zip	:	06790-2241
Country	:	US
Telephone Number	:	516-761-5099
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 BAYSIDE AVE
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-2717
Country	:	US
Telephone Number	:	516-761-5099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	06/07/2021

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