Provider Demographics
NPI:1285627851
Name:LEVINE, CAROLYN ROBBINS (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ROBBINS
Last Name:LEVINE
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 1:2210 TROY RD
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4725
Mailing Address - Country:US
Mailing Address - Phone:518-346-9498
Mailing Address - Fax:518-347-3314
Practice Address - Street 1:2210 TROY RD
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-4725
Practice Address - Country:US
Practice Address - Phone:518-346-9498
Practice Address - Fax:518-347-3314
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1755722080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01836117Medicaid
NYRA5725Medicare ID - Type Unspecified
NYF70627Medicare UPIN