Provider Demographics
NPI:1043301641
Name:LEVINSON, BARRY SIMPSON (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:SIMPSON
Last Name:LEVINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WILLIAMSON ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3625
Mailing Address - Country:US
Mailing Address - Phone:908-994-8772
Mailing Address - Fax:908-994-8748
Practice Address - Street 1:225 WILLIAMSON ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3625
Practice Address - Country:US
Practice Address - Phone:908-994-8772
Practice Address - Fax:908-994-8748
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08589700207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0199010Medicaid
F26568Medicare UPIN
NJ0199010Medicaid