=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003707159
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAY LEVINE
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2025
-----------------------------------------------------
Last Update Date | 07/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CHATEAU DRUG AND HOMECARE 181 AMSTERDAM AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-877-6390
-----------------------------------------------------
Fax | 212-877-6706
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 W 64TH ST APT 40J
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10023-7141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-374-0840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 037169
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------