Provider Demographics
NPI:1255875696
Name:LEVITIN, FELIKS Z (DAOM)
Entity type:Individual
Prefix:
First Name:FELIKS
Middle Name:Z
Last Name:LEVITIN
Suffix:
Gender:M
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 EMMONS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1724
Mailing Address - Country:US
Mailing Address - Phone:347-598-3059
Mailing Address - Fax:718-640-1714
Practice Address - Street 1:3175 EMMONS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1724
Practice Address - Country:US
Practice Address - Phone:347-598-3059
Practice Address - Fax:718-640-1714
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000900OtherLICENSE