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General NPI Number Information
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NPI Number | 1255486734
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Entity Type | Organization
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Legal Business Name | ANTHONY LEVATINO MD LLC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 2907 HILLRISE DR # B
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City | LAS CRUCES
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State | NM
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Zip | 88011-4701
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Country | US
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Telephone | 505-647-8366
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Fax | 505-647-8381
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Provider Business Mailing Address
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Address Line | PO BOX 1560
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City | LAS CRUCES
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State | NM
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Zip | 88004-1560
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Country | US
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Telephone | 505-647-8366
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Fax | 505-647-8381
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. ANTHONY PAUL LEVATINO
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Credential | MD
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Telephone | 505-647-8366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | NM
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