Provider Demographics
NPI:1407280282
Name:JENNIFER LEVINE MD PLLC
Entity Type:Organization
Organization Name:JENNIFER LEVINE MD PLLC
Other - Org Name:JENNIFER LEVINE MD PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-517-9400
Mailing Address - Street 1:240 E 79TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1257
Mailing Address - Country:US
Mailing Address - Phone:212-517-9400
Mailing Address - Fax:212-585-2604
Practice Address - Street 1:240 E 79TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1257
Practice Address - Country:US
Practice Address - Phone:212-517-9400
Practice Address - Fax:212-585-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty