Individual
EDWARD J LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1491 RICHMOND RD, STATEN ISLAND, NY 10304-2311
(718) 273-6999
(718) 273-4394
Mailing address
1491 RICHMOND RD, STATEN ISLAND, NY 10304-2311
(718) 273-6999
(718) 273-4394
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
152068
NY
261QP2300X
Primary Care Clinic/Center
152068
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00991635
—
NY
Enumeration date
10/06/2006
Last updated
03/15/2018
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