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General NPI Number Information
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NPI Number | 1932532710
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Entity Type | Individual
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Provider Name | ANNIE LEVESQUE MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 1000 10TH AVE
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City | NEW YORK
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State | NY
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Zip | 10019-1147
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Country | US
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Telephone | 212-523-6874
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Fax |
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Provider Business Mailing Address
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Address Line | 6733 DE NORMANVILLE
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City | MONTREAL
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State | QUEBEC
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Zip | H2S 2C2
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Country | CA
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Telephone | 646-515-6368
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 271669
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License Number State | NY
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