Provider Demographics
NPI:1346310216
Name:LEVICK, NADINE R (MD)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:R
Last Name:LEVICK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 BROOKDALE PLZ
Mailing Address - Street 2:EMERGENCY DEPARTMENT, BROOKDALE HOSPITAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3139
Mailing Address - Country:US
Mailing Address - Phone:718-240-6899
Mailing Address - Fax:718-240-6655
Practice Address - Street 1:1 BROOKDALE PLZ
Practice Address - Street 2:EMERGENCY DEPARTMENT, BROOKDALE HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3139
Practice Address - Country:US
Practice Address - Phone:718-240-6899
Practice Address - Fax:718-240-6655
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2011-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY257965207PP0204X, 207PE0004X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG46271Medicare UPIN
NY721V11Medicare ID - Type Unspecified