Healthcare Provider Details

I. General information

NPI: 1295123123
Provider Name (Legal Business Name): NEW LEVEL HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 06/28/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 WEISSMAN RD
LIVINGSTON MANOR NY
12758-5471
US

IV. Provider business mailing address

PO BOX 363
CALLICOON CENTER NY
12724-0363
US

V. Phone/Fax

Practice location:
  • Phone: 845-482-2278
  • Fax: 843-419-7067
Mailing address:
  • Phone: 402-740-5658
  • Fax: 843-419-7067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1045
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER WILKINSON
Title or Position: OWNER
Credential: DO
Phone: 402-740-5658