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NPI Code Detail

MEDICARE: MS. NICOLE LEVINE M.S.

MEDICARE: MS. NICOLE LEVINE M.S.
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
1106S00000XBehavior Technician
2174400000XSpecialistNY

General Provider Information

NPI Number : 1689936361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE LEVINE M.S.
Provider Business Mailing Address
First Line : 365 CLINTON AVE APT 11F
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-1160
Country : US
Telephone Number : 917-576-7951
Fax Number :
Provider Business Practice Location Address
First Line : 7000 AUSTIN ST STE 200
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4739
Country : US
Telephone Number : 718-762-7633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2012
Last Update Date : 09/15/2022

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