Healthcare Provider Details

I. General information

NPI: 1083868681
Provider Name (Legal Business Name): LEVIN & COHEN, PT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 11/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BERWICK CIRCLE
HIGHLAND MILLS NY
10930
US

IV. Provider business mailing address

2 BERWICK CIRCLE
HIGHLAND MILLS NY
10930
US

V. Phone/Fax

Practice location:
  • Phone: 917-570-7008
  • Fax: 845-928-1123
Mailing address:
  • Phone: 917-570-7008
  • Fax: 845-928-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number016291-1
License Number StateNY

VIII. Authorized Official

Name: JODI BETH LEVIN
Title or Position: PRESIDENT
Credential: MS,P.T
Phone: 917-570-7008