Provider Demographics
NPI:1285657965
Name:LEVIN, RENEE B (PHD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MORRIS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5675
Mailing Address - Country:US
Mailing Address - Phone:732-906-9600
Mailing Address - Fax:
Practice Address - Street 1:2271 HIGHWAY 33 STE 103
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1749
Practice Address - Country:US
Practice Address - Phone:609-890-4080
Practice Address - Fax:609-890-4090
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00259000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ565180M62Medicare ID - Type Unspecified