Individual
SUSAN LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
037146
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004245884
—
CT
01
—
010037146CT02
BCBS
CT
01
—
037146
CONNECTICARE
CT
Enumeration date
08/29/2006
Last updated
11/07/2022
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