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General NPI Number Information
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NPI Number | 1043455736
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Entity Type | Individual
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Provider Name | TODD MICHAEL LEVINE D.C
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Gender | Male
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 1335 W TABOR RD SUITE 211
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3038
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Country | US
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Telephone | 917-701-4510
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Fax |
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Provider Business Mailing Address
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Address Line | 3530 LONG BEACH RD APT 41
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City | OCEANSIDE
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State | NY
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Zip | 11572-5725
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Country | US
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Telephone | 917-701-4510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 007704
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC005968L
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License Number State | PA
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