Provider Demographics
NPI:1831488014
Name:LEVIN, MELISSA KANCHANAPOOMI (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:KANCHANAPOOMI
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:29 W 17TH ST FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5507
Mailing Address - Country:US
Mailing Address - Phone:917-522-1825
Mailing Address - Fax:844-758-3869
Practice Address - Street 1:29 W 17TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5507
Practice Address - Country:US
Practice Address - Phone:917-522-1825
Practice Address - Fax:844-758-3869
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278951207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology