Provider Demographics
NPI:1144402678
Name:LEVAN, ANNE-MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:LEVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1544
Mailing Address - Country:US
Mailing Address - Phone:201-444-4526
Mailing Address - Fax:201-689-0638
Practice Address - Street 1:301 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1544
Practice Address - Country:US
Practice Address - Phone:201-444-4526
Practice Address - Fax:201-689-0638
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169689207QG0300X
NJ25MA04701600207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine