Provider Demographics
NPI:1366432064
Name:LEVINE, STEVEN A (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2209 GENESEE STREET
Mailing Address - Street 2:SLEEP LAB 4TH FLOOR COLLEGE OF NURSING BUILDING
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5930
Mailing Address - Country:US
Mailing Address - Phone:315-801-3484
Mailing Address - Fax:
Practice Address - Street 1:2215 GENESEE ST
Practice Address - Street 2:SLEEP LAB-4TH FLOOR
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5930
Practice Address - Country:US
Practice Address - Phone:315-801-3484
Practice Address - Fax:315-801-3494
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2016-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY164024-1207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01460228Medicaid
NY01460228Medicaid
NY52767BMedicare PIN