Provider Demographics
NPI:1578028049
Name:LEVINSON, FLORA MAGDALENA
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:MAGDALENA
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLORA
Other - Middle Name:MAGDALENA
Other - Last Name:SIRICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:188 NEWARK POMPTON TPKE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1112
Mailing Address - Country:US
Mailing Address - Phone:877-887-3574
Mailing Address - Fax:862-279-7580
Practice Address - Street 1:188 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1112
Practice Address - Country:US
Practice Address - Phone:877-887-3574
Practice Address - Fax:862-279-7580
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist