| Brad Levine Dmd Pc | |
|
14 Maple St Suite 104 Port Washington NY 11050-2967 | |
| (516) 767-9300 | |
| (516) 767-7392 |
| Full Name | Brad Levine Dmd Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Maple St, Port Washington, New York |
| Authorized Official Name and Position | Dawn Goldstein (MANAGER) |
| Authorized Official Contact | 5167679300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brad Levine Dmd Pc 14 Maple St Suite 104 Port Washington NY 11050-2967 Ph: (516) 767-9300 | Brad Levine Dmd Pc 14 Maple St Suite 104 Port Washington NY 11050-2967 Ph: (516) 767-9300 |
| NPI Number | 1518238542 |
|---|---|
| Provider Enumeration Date | 01/23/2012 |
| Last Update Date | 02/01/2012 |
| Medicare PECOS PAC ID | 4183881279 |
|---|---|
| Medicare Enrollment ID | O20120201000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518238542 | NPI | - | NPPES |
| 02254731 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 040521 (New York) | Primary |
| Provider Name | Brad A Levine |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144203613 PECOS PAC ID: 9739346792 Enrollment ID: I20120202000071 |
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