Healthcare Provider Details

I. General information

NPI: 1295906568
Provider Name (Legal Business Name): ROBERT S. LEVITT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 EASTON AVE
SOMERSET NJ
08873-2038
US

IV. Provider business mailing address

40 BAYARD LN
PRINCETON NJ
08540-3029
US

V. Phone/Fax

Practice location:
  • Phone: 732-828-2600
  • Fax:
Mailing address:
  • Phone: 609-924-7576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRED BRILL
Title or Position: BILLER
Credential:
Phone: 623-572-7256