Provider Demographics
NPI:1255321931
Name:LEVINE, MARCI HELEN (DMD MD)
Entity type:Individual
Prefix:DR
First Name:MARCI
Middle Name:HELEN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:DMD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E 79TH ST
Mailing Address - Street 2:APT 28D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-9202
Mailing Address - Country:US
Mailing Address - Phone:646-957-7217
Mailing Address - Fax:
Practice Address - Street 1:726 BROADWAY
Practice Address - Street 2:SUITE 350
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9502
Practice Address - Country:US
Practice Address - Phone:212-443-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053187122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist