Healthcare Provider Details

I. General information

NPI: 1457568461
Provider Name (Legal Business Name): ELIZABETH LEVINE-DAVIS MA-CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 14TH ST
NEW YORK NY
10003-4201
US

IV. Provider business mailing address

131 CLEAR CREEK RD
LANGHORNE PA
19047-2306
US

V. Phone/Fax

Practice location:
  • Phone: 212-979-4166
  • Fax:
Mailing address:
  • Phone: 212-979-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number000926-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: