Provider Demographics
NPI:1386971455
Name:NATHAN LEVIN PHYSICIAN PC
Entity type:Organization
Organization Name:NATHAN LEVIN PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTSIANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-332-9244
Mailing Address - Street 1:2797 OCEAN PKWY FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7861
Mailing Address - Country:US
Mailing Address - Phone:718-743-7700
Mailing Address - Fax:
Practice Address - Street 1:2797 OCEAN PKWAY SECOND FLOOR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-743-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty