Healthcare Provider Details

I. General information

NPI: 1619151396
Provider Name (Legal Business Name): KAREN LEVINE LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 N PLEASANT ST
AMHERST MA
01002-1717
US

IV. Provider business mailing address

59 VALLEY VIEW DR
AMHERST MA
01002-3054
US

V. Phone/Fax

Practice location:
  • Phone: 413-256-0324
  • Fax:
Mailing address:
  • Phone: 413-256-0324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number503
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number132
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: