Provider Demographics
NPI:1538490461
Name:LEVINE, JUNE E (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:E
Last Name:LEVINE
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 GRAND ST
Mailing Address - Street 2:APT 505
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6376
Mailing Address - Country:US
Mailing Address - Phone:201-222-7337
Mailing Address - Fax:
Practice Address - Street 1:812 GRAND ST
Practice Address - Street 2:APT 505
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6376
Practice Address - Country:US
Practice Address - Phone:201-222-7337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY923567133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered