Provider Demographics
NPI:1770748204
Name:LEVINE, BRIAN A (MD, MS, FACOG)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:A
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD, MS, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 SEVENTH AVE FL 21
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5923
Mailing Address - Country:US
Mailing Address - Phone:212-290-8100
Mailing Address - Fax:212-269-3500
Practice Address - Street 1:810 SEVENTH AVE FL 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5923
Practice Address - Country:US
Practice Address - Phone:212-290-8100
Practice Address - Fax:212-269-3500
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59925207VE0102X
FLME148350207VE0102X
CT67357207VE0102X
NY257551207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty