Provider Demographics
NPI:1013075191
Name:DONALD LEVINE PSYCHOLOGIST PC
Entity Type:Organization
Organization Name:DONALD LEVINE PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-580-2180
Mailing Address - Street 1:203 WEST 86TH STREET
Mailing Address - Street 2:SUITE 810
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3348
Mailing Address - Country:US
Mailing Address - Phone:212-580-2180
Mailing Address - Fax:212-580-7037
Practice Address - Street 1:203 WEST 86TH STREET
Practice Address - Street 2:SUITE 810
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3348
Practice Address - Country:US
Practice Address - Phone:212-580-2180
Practice Address - Fax:212-580-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009958-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV7W521Medicare ID - Type Unspecified