Individual
JEFFREY LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
499 FARMINGTON AVE, 3RD FLOOR, FARMINGTON, CT 06032-1943
(860) 667-5450
(860) 667-8416
Mailing address
181 PATRICIA M GENOVA DR, EASTERN REHABILITATION NETWORK 5TH FLOOR, NEWINGTON, CT 06111-1500
(860) 667-5450
(860) 667-8416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006276
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004212362
—
CT
01
—
076536
MEDICARE
CT
Enumeration date
09/11/2009
Last updated
09/11/2009
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