Provider Demographics
NPI:1386013977
Name:LEVINE, LAUREN NICOLE
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:NICOLE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2914
Mailing Address - Country:US
Mailing Address - Phone:516-319-1871
Mailing Address - Fax:
Practice Address - Street 1:2381 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2914
Practice Address - Country:US
Practice Address - Phone:516-319-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist