Individual
JEREMIAH LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LIJMC - DEPT OF PEDIATRICS, 269-01 76TH AVENUE, NEW HYDE PARK, NY 11040
(718) 470-3430
Mailing address
LIJMC - DEPT OF PEDIATRICS, 269-01 76TH AVENUE, NEW HYDE PARK, NY 11040
(718) 470-3430
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
149050
NY
2080P0206X
Pediatric Gastroenterology Physician
Primary
149050
NY
Other
Enumeration date
11/10/2006
Last updated
05/29/2020
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