Provider Demographics
NPI:1164462750
Name:LEVINE, ARI (PT)
Entity Type:Individual
Prefix:DR
First Name:ARI
Middle Name:
Last Name:LEVINE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 189TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1034
Mailing Address - Country:US
Mailing Address - Phone:917-287-5127
Mailing Address - Fax:718-282-1955
Practice Address - Street 1:8055 189TH ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1034
Practice Address - Country:US
Practice Address - Phone:917-287-5127
Practice Address - Fax:718-282-1955
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017725225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2761315Medicaid
NY017725OtherPT LICENSE
NY2761315Medicaid