Provider Demographics
NPI:1205924255
Name:LEVIN, SAMUEL (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 FULTON AVE
Mailing Address - Street 2:PLANNED PARENTHOOD OF NASSAU COUNTY
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4364
Mailing Address - Country:US
Mailing Address - Phone:516-750-2500
Mailing Address - Fax:516-483-3556
Practice Address - Street 1:540 FULTON AVE
Practice Address - Street 2:PLANNED PARENTHOOD OF NASSAU COUNTY
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4364
Practice Address - Country:US
Practice Address - Phone:516-750-2500
Practice Address - Fax:516-483-3556
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY199581207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G34965Medicare UPIN