Provider Demographics
NPI:1457506107
Name:LEVINE, REBECCA (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1575 BLONDELL AVE
Mailing Address - Street 2:STE 125
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2660
Mailing Address - Country:US
Mailing Address - Phone:718-644-7394
Mailing Address - Fax:718-405-8292
Practice Address - Street 1:1575 BLONDELL AVE
Practice Address - Street 2:STE 125
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2660
Practice Address - Country:US
Practice Address - Phone:718-644-7394
Practice Address - Fax:718-405-8292
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-22
Last Update Date:2011-10-12
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Provider Licenses
StateLicense IDTaxonomies
NY249666-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery