Healthcare Provider Details

I. General information

NPI: 1497748420
Provider Name (Legal Business Name): JEFFREY LEVINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 LENOX RD
BROOKLYN NY
11203-2017
US

IV. Provider business mailing address

445 LENOX RD BOX 1262
BROOKLYN NY
11203-2017
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-4790
  • Fax:
Mailing address:
  • Phone: 718-245-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number221081-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number221081-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: