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Individual

DR. ETHAN LEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 735-4623
(607) 271-3711
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050

Taxonomy

Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
221196
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02886946
NY
05
102254461
PA
Enumeration date
08/03/2006
Last updated
06/13/2016
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