Provider Demographics
NPI:1366758021
Name:LEVIN & ASSOCIATES PLLC
Entity type:Organization
Organization Name:LEVIN & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOREAN
Authorized Official - Middle Name:DALISE
Authorized Official - Last Name:YOCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-842-6609
Mailing Address - Street 1:170 THOMPSON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-2608
Mailing Address - Country:US
Mailing Address - Phone:304-842-6609
Mailing Address - Fax:304-842-6619
Practice Address - Street 1:170 THOMPSON DR STE 103
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-2608
Practice Address - Country:US
Practice Address - Phone:304-842-6609
Practice Address - Fax:304-842-6619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV237305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0162894000Medicaid