Individual
MS. ALICE RUTH LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3 PHYLLIS LN, CORAM, NY 11727-2718
(631) 736-1201
Mailing address
3 PHYLLIS LN, CORAM, NY 11727-2718
(631) 736-1201
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
000535-1
NY
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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