Levine, Brad A

Levine, Brad A is an sole proprietor health care provider with primary practice located at 14 Maple St , Port Washington NY 11050-2946. He recently has 2 registered licenses in different health care specialties including Dental Providers / Endodontics, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Endodontics is his primary health care specialty. Levine, Brad A can be contacted via phone (516) 767-9300.

Contact Information

Primary practice address
14 Maple St Port Washington NY 11050-2946
Phone: (516) 767-9300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 040521 New York
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 040521 New York

Profile Details

NPI number 1144203613
LBN Legal business name Levine, Brad A
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 29th, 2005
Last updated Sep 24th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144203613 NPPES
New York MEDICAID 02254731

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