Individual
DR. JONATHAN D LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 344-6174
(860) 344-6062
Mailing address
PO BOX 1590, NEW HAVEN, CT 06506-1590
(203) 397-8000
(203) 389-1540
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
031481
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004400862
AETNA/US HEALTHCARE#
CT
01
—
001314814P1
BLUE CARE FAMILY PLAN#
CT
01
—
4832
CONNECTICARE#
CT
01
—
500HBL066CT01
BC/BS#
CT
01
—
5024698
CIGNA#
CT
Enumeration date
07/03/2006
Last updated
07/09/2007
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