Organization
ELLEN LEVAN, MD, PC
Active
Other names
BRANFORD MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN LEVAN MD (PHYSICIAN)
(973) 424-0080
Entity
Organization
Contact information
Practice address
23 BRANFORD PL, NEWARK, NJ 07102-2711
(973) 424-0080
(973) 424-0088
Mailing address
23 BRANFORD PL, NEWARK, NJ 07102-2711
(973) 424-0080
(973) 424-0088
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
26NP05605400
NJ
207R00000X
Internal Medicine Physician
25MA04281900
NJ
207R00000X
Internal Medicine Physician
Primary
25MA07184800
NJ
2080P0207X
Pediatric Hematology & Oncology Physician
25MA05569500
NJ
363AM0700X
Medical Physician Assistant
25MP00016700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7528001
—
NJ
05
—
8449007
—
NJ
Enumeration date
07/29/2010
Last updated
09/30/2010
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