Healthcare Provider Details

I. General information

NPI: 1215586011
Provider Name (Legal Business Name): ISROEL LEVIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MAPLE LEAF RD
MONSEY NY
10952-3030
US

IV. Provider business mailing address

174 REAGAN RD UNIT 201
SPRING VALLEY NY
10977-7956
US

V. Phone/Fax

Practice location:
  • Phone: 845-262-0544
  • Fax:
Mailing address:
  • Phone: 845-262-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099349
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: