Provider Demographics
NPI:1679656169
Name:LEVINE, ALLEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:D
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:32 GLEN DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1020
Mailing Address - Country:US
Mailing Address - Phone:845-294-3933
Mailing Address - Fax:
Practice Address - Street 1:75 CRYSTAL RUN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-7000
Practice Address - Country:US
Practice Address - Phone:845-703-5000
Practice Address - Fax:845-703-5010
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY104150174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC11990Medicare UPIN