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General NPI Number Information
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NPI Number | 1083781231
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Entity Type | Individual
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Provider Name | LAWRENCE PAUL LEVINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 2909 BERLIN TPKE
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City | NEWINGTON
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State | CT
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Zip | 06111-4115
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Country | US
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Telephone | 860-436-3757
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2699 DEPT 200
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City | HARTFORD
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State | CT
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Zip | 06146-2699
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Country | US
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Telephone | 866-898-7138
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Fax | 616-975-9824
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 033761
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 033761
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License Number State | CT
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