Individual
ETHAN LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 DUBOIS ST, NEWBURGH, NY 12550-4851
(845) 561-4400
Mailing address
720 PELHAM RD APT 3C, NEW ROCHELLE, NY 10805-1016
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
020831
NY
363AM0700X
Medical Physician Assistant
3863
CT
Other
Enumeration date
05/24/2017
Last updated
02/13/2018
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