Provider Demographics
NPI:1194037408
Name:LEVINE, DANIELLE E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:E
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MOLOFSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:221 LONGWOOD AVE
Mailing Address - Street 2:DERMATOLOGY DEPARTMENT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5804
Mailing Address - Country:US
Mailing Address - Phone:617-732-4918
Mailing Address - Fax:617-582-6060
Practice Address - Street 1:221 LONGWOOD AVE
Practice Address - Street 2:DERMATOLOGY DEPARTMENT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5804
Practice Address - Country:US
Practice Address - Phone:617-732-4918
Practice Address - Fax:617-582-6060
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245072207N00000X
MA258369207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology