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Individual

DR. LAWRENCE PAUL LEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2909 BERLIN TPKE, NEWINGTON, CT 06111-4115
(860) 436-3757
Mailing address
PO BOX 2699, DEPT 200, HARTFORD, CT 06146-2699
(866) 898-7138
(616) 975-9824

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
033761
CT
207Q00000X
Family Medicine Physician
Primary
033761
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
930109469
RAILROAD MEDICARE
Enumeration date
11/30/2006
Last updated
05/15/2014
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