1790956449 NPI number — GLORIA LEVIN AND ASSOCIATES

Table of content: CYNTHIA ANN MARTIN CPNP (NPI 1912993353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790956449 NPI number — GLORIA LEVIN AND ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GLORIA LEVIN AND ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790956449
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1217 GREEN BAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMETTE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60091-1643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-251-1717
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1217 GREEN BAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMETTE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60091-1643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-251-1717
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEVIN
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OCCUPATIONAL THERAPIST - OWNER
Authorized Official Telephone Number:
847-251-1717

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)