Healthcare Provider Details

I. General information

NPI: 1366428294
Provider Name (Legal Business Name): DANIEL Q. LEVIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CLARKSON AVE 2ND FLOOR
BROOKLYN NY
11203-2056
US

IV. Provider business mailing address

450 CLARKSON AVE BOX 1262
BROOKLYN NY
11203-2056
US

V. Phone/Fax

Practice location:
  • Phone: 718-270-1603
  • Fax: 718-270-2667
Mailing address:
  • Phone: 718-270-8867
  • Fax: 718-270-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25MA07030400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number183991-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA07030400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: