Levine, Jack M.

Levine, Jack M. is an individual health care provider with primary practice located at 6940 Main St , Kew Gardens Hills NY 11367-1723. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Levine, Jack M. can be contacted via phone (718) 268-5282.

Contact Information

Primary practice address
6940 Main St Kew Gardens Hills NY 11367-1723
Phone: (718) 268-5282
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 145681 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 145681 New York

Profile Details

NPI number 1962588301
LBN Legal business name Levine, Jack M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Dec 28th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962588301 NPPES
New York MEDICAID 00801390

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