Healthcare Provider Details

I. General information

NPI: 1750458444
Provider Name (Legal Business Name): ERIC J LEVENE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 N BROADWAY SUITE F
WHITE PLAINS NY
10601-2214
US

IV. Provider business mailing address

15 N BROADWAY SUITE F
WHITE PLAINS NY
10601-2214
US

V. Phone/Fax

Practice location:
  • Phone: 914-948-4422
  • Fax: 914-948-9536
Mailing address:
  • Phone: 914-948-4422
  • Fax: 914-948-9536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number188161
License Number StateNY

VII. Legacy identifiers

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

# 1
Identifier000000087267
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerGHI HMO
# 2
Identifier2695674
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerGHI PPO
# 3
IdentifierWP435
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerOXFORD HEALTH PLANS
# 4
IdentifierWP0066
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerHEALTHNET
# 5
Identifier6411958
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerCIGNA
# 6
Identifier4348856
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerAETNA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: