Provider Demographics
NPI:1194788299
Name:LEVIN, RICHARD I (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:I
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 WEST 106TH STREET
Mailing Address - Street 2:SUITE 6B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3629
Mailing Address - Country:US
Mailing Address - Phone:917-971-7573
Mailing Address - Fax:
Practice Address - Street 1:225 WEST 106TH STREET
Practice Address - Street 2:SUITE 6B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3629
Practice Address - Country:US
Practice Address - Phone:917-971-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY124330207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC07855Medicare UPIN