Individual
JEFFREY D LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
372 CHANDLER ST, WORCESTER, MA 01602
(508) 752-4669
(508) 767-1897
Mailing address
372 CHANDLER ST, WORCESTER, MA 01602
(508) 752-4669
(508) 767-1897
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
48153
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004191
NHP
—
05
—
0152463
—
MA
01
—
048153
TUFTS
—
01
—
15504
HPHC
—
01
—
4020015
AETNA
—
01
—
999510
NETWORK HEALTH
—
01
—
N01936
BCBS
—
Enumeration date
10/18/2005
Last updated
05/02/2011
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