Individual
LARRY B LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 SAYBROOK RD, SUITE N100, MIDDLETOWN, CT 06457-4700
(860) 344-1801
(860) 358-8657
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4820
(860) 358-8661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
030892
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001308924
—
CT
Enumeration date
06/26/2006
Last updated
04/11/2017
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