Provider Demographics
NPI:1295797017
Name:LEVINE, JANE ROCHELLE (MS, RD, CD-N)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:ROCHELLE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MS, RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SWEETBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2223
Mailing Address - Country:US
Mailing Address - Phone:914-693-0533
Mailing Address - Fax:914-693-2066
Practice Address - Street 1:250 E HARTSDALE AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-3571
Practice Address - Country:US
Practice Address - Phone:914-725-5703
Practice Address - Fax:914-693-2066
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000398133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered