Provider Demographics
NPI:1770567737
Name:LEVINE, PAMELA M (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:M
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:33 PROSPECT PARK W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2393
Mailing Address - Country:US
Mailing Address - Phone:718-399-7100
Mailing Address - Fax:718-399-7105
Practice Address - Street 1:33 PROSPECT PARK W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2393
Practice Address - Country:US
Practice Address - Phone:718-399-7100
Practice Address - Fax:718-399-7105
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224839-1207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02527439Medicaid
NY9J2661Medicare ID - Type Unspecified
NYA400066249Medicare PIN
NYI03471Medicare UPIN