Provider Demographics
NPI:1598789935
Name:LEVIN, BELLA (MD)
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3315
Mailing Address - Country:US
Mailing Address - Phone:718-567-2800
Mailing Address - Fax:718-567-7775
Practice Address - Street 1:5701 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3315
Practice Address - Country:US
Practice Address - Phone:718-567-2800
Practice Address - Fax:718-567-7775
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY199899OtherHEALTH FIRST
NY01598301Medicaid
NY112930314LE-01OtherCARE PLUS
NYQN00626-07OtherAMERICHOICE
NY275850301OtherHEALTH PLUS
NY01598301Medicaid
NY112930314LE-01OtherCARE PLUS