Provider Demographics
NPI:1346395951
Name:LEVINE, DEBRA (CHIROPRACTIC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:CHIROPRACTIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CRESCENT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-650-6076
Mailing Address - Fax:516-671-9074
Practice Address - Street 1:44 CRESCENT BEACH RD
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:516-650-6076
Practice Address - Fax:516-671-9074
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCHX005366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X1B351Medicare ID - Type Unspecified