Provider Demographics
NPI:1306956248
Name:REVAN, SHARON LEVINA (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LEVINA
Last Name:REVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:502 PARK RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3122
Mailing Address - Country:US
Mailing Address - Phone:914-649-9952
Mailing Address - Fax:
Practice Address - Street 1:3 BARKER AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1509
Practice Address - Country:US
Practice Address - Phone:914-949-1199
Practice Address - Fax:914-949-1245
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY191108207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01666962Medicaid
F60938Medicare UPIN
78H191Medicare ID - Type Unspecified