Provider Demographics
NPI:1780777235
Name:LEVIN, STEVEN JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JONATHAN
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:277 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1311
Mailing Address - Country:US
Mailing Address - Phone:732-235-7297
Mailing Address - Fax:732-235-6726
Practice Address - Street 1:277 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1311
Practice Address - Country:US
Practice Address - Phone:732-235-7297
Practice Address - Fax:732-235-6726
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05343000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1515403Medicaid
NJ1515403Medicaid
NJ400343A02Medicare PIN
D17553Medicare UPIN