Provider Demographics
NPI:1306053004
Name:LEVINE, EVA (PHD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 GRAMERCY PARK E APT 10T
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1777
Mailing Address - Country:US
Mailing Address - Phone:917-817-7523
Mailing Address - Fax:212-473-5766
Practice Address - Street 1:32 GRAMERCY PARK S
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1707
Practice Address - Country:US
Practice Address - Phone:917-817-7523
Practice Address - Fax:212-473-5766
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016232103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3680483OtherOXFORD