Provider Demographics
NPI:1518395318
Name:LEVITAN, BETH (APRN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:LEVITAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BATYA
Other - Middle Name:BETH
Other - Last Name:LEVITAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANP-C
Mailing Address - Street 1:17B MERWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-7902
Mailing Address - Country:US
Mailing Address - Phone:203-415-3373
Mailing Address - Fax:
Practice Address - Street 1:850 MIX AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2102
Practice Address - Country:US
Practice Address - Phone:203-415-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005440363LP0808X
CT5440363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health