# ROGER G LEVINE MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083004907
- **Authorized official:** DR. ROGER G LEVINE (OWNER)
- **Authorized official phone:** (315) 469-2827

## Contact information

- **Practice address:** 4914 WEST SENECA TURNPKIE, SYRACUSE, NY 13215
- **Practice address phone:** (315) 469-2827
- **Practice address fax:** (888) 224-8297
- **Mailing address:** 4914 WEST SENECA TURNPKIE, SYRACUSE, NY 13215
- **Mailing address phone:** (315) 469-2827
- **Mailing address fax:** (888) 224-8297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 172860 | NY | Yes |

## Other

- **Enumeration date:** 01/30/2015
- **Last updated:** 01/30/2015