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General NPI Number Information
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NPI Number | 1871554329
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Entity Type | Individual
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Provider Name | BENJAMIN LEVINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 1157 BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-2325
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Country | US
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Telephone | 516-295-4481
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Fax | 516-295-4809
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Provider Business Mailing Address
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Address Line | 1157 BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-2325
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Country | US
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Telephone | 516-295-4481
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Fax | 516-295-4809
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA07860800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 238356
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License Number State | NY
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