Healthcare Provider Details

I. General information

NPI: 1093753816
Provider Name (Legal Business Name): RICHARD M LEVINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 ROUTE 37 W
TOMS RIVER NJ
08755-4999
US

IV. Provider business mailing address

PO BOX 40409
BELFAST ME
04915-1255
US

V. Phone/Fax

Practice location:
  • Phone: 732-602-4480
  • Fax:
Mailing address:
  • Phone: 732-602-4480
  • Fax: 609-817-3276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA62913
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA06291300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: