Provider Demographics
NPI:1750458444
Name:LEVENE, ERIC J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:LEVENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15 N BROADWAY
Mailing Address - Street 2:SUITE F
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2214
Mailing Address - Country:US
Mailing Address - Phone:914-948-4422
Mailing Address - Fax:914-948-9536
Practice Address - Street 1:15 N BROADWAY
Practice Address - Street 2:SUITE F
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2214
Practice Address - Country:US
Practice Address - Phone:914-948-4422
Practice Address - Fax:914-948-9536
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY188161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000087267OtherGHI HMO
NY2695674OtherGHI PPO
NYWP435OtherOXFORD HEALTH PLANS
NYWP0066OtherHEALTHNET
NY6411958OtherCIGNA
NY4348856OtherAETNA
NYWP0066OtherHEALTHNET