Provider Demographics
NPI:1326173154
Name:LEVIN, CHERYL LYNN (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-1300
Mailing Address - Fax:617-421-1362
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1300
Practice Address - Fax:617-421-1362
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2021-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN19768207N00000X
GA062910207N00000X
CAA 105466207N00000X
MA250248207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0029212Medicare PIN