Provider Demographics
NPI:1962764654
Name:LEVINE, RONA JAN (MS SPECI ED)
Entity type:Individual
Prefix:MS
First Name:RONA
Middle Name:JAN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MS SPECI ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SILVERSMITH DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2602
Mailing Address - Country:US
Mailing Address - Phone:914-419-8693
Mailing Address - Fax:
Practice Address - Street 1:2 SILVERSMITH DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2602
Practice Address - Country:US
Practice Address - Phone:914-419-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-09
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
NY1-14-16937103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist