Provider Demographics
NPI:1306100763
Name:LEVITINA, NINA N/A (MSSPED)
Entity type:Individual
Prefix:MRS
First Name:NINA
Middle Name:N/A
Last Name:LEVITINA
Suffix:
Gender:F
Credentials:MSSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 E 3RD ST
Mailing Address - Street 2:APT 7B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5357
Mailing Address - Country:US
Mailing Address - Phone:646-705-3702
Mailing Address - Fax:718-382-7215
Practice Address - Street 1:2411 E 3RD ST
Practice Address - Street 2:APT 7B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5357
Practice Address - Country:US
Practice Address - Phone:646-705-3702
Practice Address - Fax:718-382-7215
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1181884174400000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY174400000XOtherINDIVIDUALS