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Individual

DR. FREDRIC M LEVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1000 MAIN ST, PORT JEFFERSON, NY 11777-2250
(631) 473-6622
Mailing address
1000 MAIN ST, PORT JEFFERSON, NY 11777-2250
(631) 473-6622

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3559
NY
103TC0700X
Clinical Psychologist
Primary
3559
NY
103TH0004X
Health Psychologist
3559
NY
103TH0100X
Health Service Psychologist
3559
NY

Other

Enumeration date
03/25/2009
Last updated
03/25/2009
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