Provider Demographics
NPI:1083834188
Name:LEVITAN, JANE ANN (NP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:LEVITAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 POPHAM RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4252
Mailing Address - Country:US
Mailing Address - Phone:914-722-1789
Mailing Address - Fax:914-722-1789
Practice Address - Street 1:45 POPHAM RD
Practice Address - Street 2:SUITE D
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4252
Practice Address - Country:US
Practice Address - Phone:914-722-1789
Practice Address - Fax:914-722-1789
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF400363363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY98V171Medicare ID - Type Unspecified