Healthcare Provider Details

I. General information

NPI: 1669472403
Provider Name (Legal Business Name): WILLIAM M LEVINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 GRASSLANDS RD STE. 200
VALHALLA NY
10595-1503
US

IV. Provider business mailing address

503 GRASSLANDS RD STE 200
VALHALLA NY
10595-1503
US

V. Phone/Fax

Practice location:
  • Phone: 914-304-5250
  • Fax: 914-345-1752
Mailing address:
  • Phone: 914-304-5250
  • Fax: 914-345-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number131376
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierA400021451
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerMEDICARE PTAN
# 2
Identifier01071838
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: