Provider Demographics
NPI:1245303650
Name:LEVENSON, ARYEH LEIB (MD)
Entity type:Individual
Prefix:
First Name:ARYEH
Middle Name:LEIB
Last Name:LEVENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:DANA
Other - Last Name:LEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8717 DIMOND D CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1931
Mailing Address - Country:US
Mailing Address - Phone:907-771-0536
Mailing Address - Fax:907-771-0537
Practice Address - Street 1:8717 DIMOND D CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1931
Practice Address - Country:US
Practice Address - Phone:907-771-0536
Practice Address - Fax:907-771-0537
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAL35992084P0800X
AKAK35992084P0802X
AK35992084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK8EL815Medicare PIN
AK8EZ99AMedicare PIN
AK8EL813Medicare PIN
AK8EZ09BMedicare PIN
F87523Medicare UPIN
AKMD3599Medicaid
AK8EL814Medicare PIN
AK8EK383Medicare PIN
AK8EZ15BMedicare PIN
AK8EZ24BMedicare ID - Type Unspecified
AK8EK290Medicare PIN
AK8EZ88AMedicare PIN
AK8EL812Medicare PIN