Healthcare Provider Details

I. General information

NPI: 1073873667
Provider Name (Legal Business Name): YOSEF LEVIN M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PARK AVENUE
ISLAND HEIGHTS NJ
08732-0354
US

IV. Provider business mailing address

13 PARK AVENUE PO BOX 354
ISLAND HEIGHTS NJ
08732-0354
US

V. Phone/Fax

Practice location:
  • Phone: 732-674-7927
  • Fax:
Mailing address:
  • Phone: 732-674-7927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: