Provider Demographics
NPI:1013432145
Name:LEVITINE, DANIELLE ELENA (MS BCDMT LCAT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELENA
Last Name:LEVITINE
Suffix:
Gender:F
Credentials:MS BCDMT LCAT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ELENA
Other - Last Name:FISCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS BCDMT LCAT
Mailing Address - Street 1:112 W 27TH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6240
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 W 27TH ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6240
Practice Address - Country:US
Practice Address - Phone:212-645-6903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002116225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist