MEDICARE: CORINNE LEVITUS D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	310581	NY

General Provider Information

NPI Number	:	1427411123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINNE LEVITUS D.O.

Provider Business Mailing Address
First Line	:	156 ROUTE 59 STE C1
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-5010
Country	:	US
Telephone Number	:	845-357-3838
Fax Number	:	845-357-6413

Provider Business Practice Location Address
First Line	:	156 ROUTE 59 STE C1
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-5010
Country	:	US
Telephone Number	:	845-357-3838
Fax Number	:	845-357-6413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	01/12/2022

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Directions to “ CORINNE LEVITUS D.O.” Practice Location

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