Healthcare Provider Details

I. General information

NPI: 1891087755
Provider Name (Legal Business Name): NAFTOLI DAVID LEVIN P.A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2290 W COUNTY LINE RD
JACKSON NJ
08527-2267
US

IV. Provider business mailing address

2290 W COUNTY LINE RD
JACKSON NJ
08527-2267
US

V. Phone/Fax

Practice location:
  • Phone: 732-645-9988
  • Fax:
Mailing address:
  • Phone: 732-645-9988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00504800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number014760
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: