Provider Demographics
NPI:1700837234
Name:LEVINE, ROBERT SETH (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SETH
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BELMILL RD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4507
Mailing Address - Country:US
Mailing Address - Phone:516-287-2969
Mailing Address - Fax:
Practice Address - Street 1:4 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4080
Practice Address - Country:US
Practice Address - Phone:631-689-3188
Practice Address - Fax:732-244-2804
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255668207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14050OtherUNIVERSITY HEALTH PLANS
NJ189069OtherAMERICAID/AMERIGROUP
NJ14050OtherUNIVERSITY HEALTH PLANS
NJI45152Medicare UPIN