Provider Demographics
NPI:1174591895
Name:LEVIN, ZINAIDA (MD)
Entity type:Individual
Prefix:DR
First Name:ZINAIDA
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 CHAPMAN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2096
Mailing Address - Country:US
Mailing Address - Phone:781-575-1266
Mailing Address - Fax:781-575-9948
Practice Address - Street 1:510 CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2096
Practice Address - Country:US
Practice Address - Phone:781-575-1266
Practice Address - Fax:781-575-9948
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ18999OtherBCBS
MA154813OtherTUFTS
MA3182169Medicaid
G67181Medicare UPIN
MAA23521Medicare ID - Type Unspecified