Individual
DR. HEIDI JILL LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 675-4149
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 675-4149
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
177938-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02362316
—
NY
Enumeration date
05/15/2006
Last updated
10/09/2007
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