Provider Demographics
NPI:1750478251
Name:LEVINE, HOWARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 HAZEL PLACE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1109
Mailing Address - Country:US
Mailing Address - Phone:516-295-2128
Mailing Address - Fax:718-444-3728
Practice Address - Street 1:930 EAST 83 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3813
Practice Address - Country:US
Practice Address - Phone:718-444-6500
Practice Address - Fax:718-444-3728
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY140622208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00629263Medicaid
NYC10382Medicare UPIN