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General NPI Number Information
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NPI Number | 1578910097
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Entity Type | Individual
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Provider Name | REBECCA A. LEVIN
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Gender | Female
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 840 HARRISON AVE. 1ST FLOOR MENINO BLDG
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City | BOSTON
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State | MA
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Zip | 02118
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Country | US
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Telephone | 617-414-4991
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Fax |
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Provider Business Mailing Address
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Address Line | BMC PROVIDER ENROLLMENT OFFICE 960 MASSACHUSETTS AVE,.2ND FLOOR
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City | BOSTON
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State | MA
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Zip | 02118-2560
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Country | US
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Telephone | 617-414-5405
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 291408
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 291408
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License Number State | MA
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