Provider Demographics
NPI:1295261899
Name:LEVINE, ERIKA ALEXIA (MSED)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ALEXIA
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CENTERPORT RD
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1760
Mailing Address - Country:US
Mailing Address - Phone:646-660-0543
Mailing Address - Fax:
Practice Address - Street 1:175 CENTERPORT RD
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1760
Practice Address - Country:US
Practice Address - Phone:646-660-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist