Provider Demographics
NPI:1700986247
Name:LEVINE, RANDY L (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:L
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0208
Mailing Address - Country:US
Mailing Address - Phone:212-717-1020
Mailing Address - Fax:
Practice Address - Street 1:920 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0208
Practice Address - Country:US
Practice Address - Phone:212-717-1020
Practice Address - Fax:212-717-0972
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145824207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology