Healthcare Provider Details

I. General information

NPI: 1679904460
Provider Name (Legal Business Name): CYNTHIA LEVIN APRN-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MYRON ST SUITE A
WEST SPRINGFIELD MA
01089-1598
US

IV. Provider business mailing address

57 DAVIS AVE
NEWTON MA
02465-1925
US

V. Phone/Fax

Practice location:
  • Phone: 413-592-1980
  • Fax: 413-439-0100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN135795
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: