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General NPI Number Information
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NPI Number | 1942517321
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Entity Type | Organization
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Legal Business Name | SUNNYSIDE MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 1491 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2311
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Country | US
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Telephone | 718-273-6999
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Fax | 718-273-4394
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Provider Business Mailing Address
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Address Line | 1491 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2311
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Country | US
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Telephone | 718-273-6999
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Fax | 718-273-4394
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Authorized Official
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Title or Position | HEALTH CARE PROVIDER
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Name | DR. EDWARD J LEVINE
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Credential | MD
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Telephone | 718-273-6999
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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 | 152068
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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