MEDICARE: DAVID LEVINE DC

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	111N00000X	Chiropractor	38MC00468000	NJ

General Provider Information

NPI Number	:	1730389511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LEVINE DC

Provider Business Mailing Address
First Line	:	380 BRADLEY AVE
Second Line	:
City	:	NORTHVALE
State	:	NJ
Zip	:	07647-1608
Country	:	US
Telephone Number	:	201-739-4200
Fax Number	:	201-430-1322

Provider Business Practice Location Address
First Line	:	457 WASHINGTON AVE APT B
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628-1243
Country	:	US
Telephone Number	:	201-739-4200
Fax Number	:	201-430-1322

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

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	07/20/2007

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Directions to “ DAVID LEVINE DC” Practice Location

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