Provider Demographics
NPI:1275838112
Name:LEVIN, RENA M (MS)
Entity Type:Individual
Prefix:MRS
First Name:RENA
Middle Name:M
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13518 78TH AVE APT E
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3273
Mailing Address - Country:US
Mailing Address - Phone:718-406-2080
Mailing Address - Fax:
Practice Address - Street 1:13518 78TH AVE APT E
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3273
Practice Address - Country:US
Practice Address - Phone:718-406-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist