Healthcare Provider Details

I. General information

NPI: 1649151432
Provider Name (Legal Business Name): ALLYSA BROOKE LEE-LEVINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLYSA BROOKE LEE-LEVINE

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2259 W HILLSBORO BLVD # A
DEERFIELD BEACH FL
33442-1106
US

IV. Provider business mailing address

3 HONEYSUCKLE CT
EAST BRUNSWICK NJ
08816-2776
US

V. Phone/Fax

Practice location:
  • Phone: 954-725-4160
  • Fax:
Mailing address:
  • Phone: 732-613-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02352900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: