Provider Demographics
NPI:1376605766
Name:LEVINE, H YALE (CHIROPRACTOR DC)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:YALE
Last Name:LEVINE
Suffix:
Gender:M
Credentials:CHIROPRACTOR DC
Other - Prefix:
Other - First Name:H
Other - Middle Name:YALE
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:134 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6818
Mailing Address - Country:US
Mailing Address - Phone:973-455-1313
Mailing Address - Fax:973-455-1314
Practice Address - Street 1:134 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6818
Practice Address - Country:US
Practice Address - Phone:973-455-1313
Practice Address - Fax:973-455-1314
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00172100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ450659Medicare ID - Type Unspecified