Provider Demographics
NPI:1326141326
Name:LEVIN, JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:JEFFREY
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:257 MONMOUTH ROAD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755
Mailing Address - Country:US
Mailing Address - Phone:732-531-1155
Mailing Address - Fax:732-905-9438
Practice Address - Street 1:257 MONMOUTH ROAD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755
Practice Address - Country:US
Practice Address - Phone:732-531-1155
Practice Address - Fax:732-531-8155
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC02673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LE461517Medicare UPIN