Individual
ELLEN LEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
26-01 PELLACK DRIVE, 2ND FLOOR, FAIR LAWN, NJ 07410
(201) 791-9340
(201) 791-9481
Mailing address
26-01 PELLACK DRIVE, 2ND FLOOR, FAIR LAWN, NJ 07410
(201) 791-9340
(201) 791-9481
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07184800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01696226
—
NY
Enumeration date
11/22/2005
Last updated
10/24/2012
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