Provider Demographics
NPI:1790951648
Name:LEVIN, SARAH BUSHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BUSHELL
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1351 ROUTE 55
Mailing Address - Street 2:SUIOTE 200
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5108
Mailing Address - Country:US
Mailing Address - Phone:845-475-9500
Mailing Address - Fax:845-475-9915
Practice Address - Street 1:1 COLUMBIA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3923
Practice Address - Country:US
Practice Address - Phone:845-473-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2016-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY235476207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03210602Medicaid
NYA400095151Medicare PIN