Provider Demographics
NPI:1790845352
Name:LEVAN, ANITA K (PA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:K
Last Name:LEVAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:39 DUNDERBERG RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-2113
Mailing Address - Country:US
Mailing Address - Phone:718-920-4067
Mailing Address - Fax:718-655-5470
Practice Address - Street 1:MMC - SATP - UNIT 1
Practice Address - Street 2:3550 JEROME AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4067
Practice Address - Fax:718-655-5470
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-08-01
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Provider Licenses
StateLicense IDTaxonomies
NY001305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant