Provider Demographics
NPI:1245294677
Name:LEVINN, JEFFREY CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CRAIG
Last Name:LEVINN
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 1:1050 PITTSFORD VICTOR RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3812
Mailing Address - Country:US
Mailing Address - Phone:585-383-1160
Mailing Address - Fax:585-383-8945
Practice Address - Street 1:1050 PITTSFORD VICTOR RD
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3812
Practice Address - Country:US
Practice Address - Phone:585-383-1160
Practice Address - Fax:585-383-8945
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157364208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00851276Medicaid
NY101053DLOtherPREFERRED CARE
NY4345437OtherAETNA
NY101053DLOtherPREFERRED CARE