1093800575 NPI number — MS. TERRI A LEVINE R.N. N.P.

Table of content: DR. MICHAEL T MCAULIFFE M.D. (NPI 1538156252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093800575 NPI number — MS. TERRI A LEVINE R.N. N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVINE
Provider First Name:
TERRI
Provider Middle Name:
A
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
R.N. N.P.
Provider Gender Code:
F

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:
1093800575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2337
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13220-2337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-422-6705
Provider Business Mailing Address Fax Number:
315-422-3909

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 HULBERT ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13021-3430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-252-0810
Provider Business Practice Location Address Fax Number:
315-252-5179
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  F300731 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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