Healthcare Provider Details

I. General information

NPI: 1013432145
Provider Name (Legal Business Name): DANIELLE ELENA LEVITINE MS BCDMT LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE ELENA FISCO MS BCDMT LCAT

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 08/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W 27TH ST FL 7
NEW YORK NY
10001-6240
US

IV. Provider business mailing address

112 W 27TH ST FL 7
NEW YORK NY
10001-6240
US

V. Phone/Fax

Practice location:
  • Phone: 212-645-6903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number002116
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: