Provider Demographics
NPI:1679508469
Name:LEVIN, GALE A (MD)
Entity Type:Individual
Prefix:DR
First Name:GALE
Middle Name:A
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 1:211 OSBORN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2850
Mailing Address - Country:US
Mailing Address - Phone:203-654-9002
Mailing Address - Fax:203-643-2073
Practice Address - Street 1:211 OSBORN AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2850
Practice Address - Country:US
Practice Address - Phone:203-654-9002
Practice Address - Fax:203-643-2073
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0272862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT224740000OtherMAGELLAN FOR CHN
CT329553OtherVALU OPT CHN CT SAGA
CTCTGA000525OtherDMHAS
CT004212148Medicaid
CTB000698OtherDMHAS
CT00127286402OtherBC FAMILY PLAN
CT010027286CT08OtherANTHEM BEH, BCBS
CT329553OtherVALU OPT CHN CT SAGA