BRUCE LEVINE (NPI# 1205093242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205093242 |
| Entity Type | Individual |
| Full Name | BRUCE LEVINE |
| Credential | MD |
| Practice Address |
24670 Gotham Street Rd Carriage House Watertown NY 13601-4290 |
| Practice Telephone | 3033857368 |
| Mailing Telephone | 3033857368 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2016-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
TD60632655 | WA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
242658 | NY | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
46758 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 50385755 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073660734 | Bruce E Levine | Psychologist | 5725 Dragon Way, Suite 303, Cincinnati, OH 45227-4593 | 2007-01-04 |
| 1447347737 | Bruce M Levine | Psychiatry & Neurology | 312 W 91st St, New York, NY 10024-1030 | 2006-10-06 |
| 1508897836 | Bruce Alan Levine | Psychologist | 9107 Wilshire Blvd, Suite 475, Beverly Hills, CA 90210-5531 | 2006-07-05 |
| 1699739250 | Bruce Levine | Physical Therapist | 5 Lincoln Road, Foxboro, MA 02035 | 2006-04-12 |
| 1003315250 | Bruce Marshall Levine | Psychologist | 91 Northwest Dr, Plainville, CT 06062-1534 | 2018-02-02 |
| 1437379583 | Bruce D Levine | Podiatrist | 1360 W 6th St, 150w, San Pedro, CA 90732-3514 | 2007-04-30 |
| 1124146105 | Bruce L. Levine | Psychologist | 53 S Main St, Suite 302, Hanover, NH 03755-2022 | 2007-03-27 |
| 1316022858 | Bruce Alan Levine | Chiropractor | 49 Berry Hill Rd, Syosset, NY 11791-2624 | 2006-10-25 |
| 1255368817 | Bruce Jay Levine | Obstetrics & Gynecology | 120 Madison Ave, Suite B, Mount Holly, NJ 08060-2055 | 2006-06-27 |
| 1063478196 | Bruce J Levine | Podiatrist | 2521 Countryside Blvd, Clearwater, FL 33763-1605 | 2006-04-26 |
| Street Address |
24670 GOTHAM STREET RD CARRIAGE HOUSE |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-4290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700297686 | Scott F Ulberg | Psychiatry & Neurology | 211 J.b. Wise Plaza, Watertown, NY 13601 | 2014-05-14 |
| 1407896418 | Michael F. Larson | Psychiatry & Neurology | 485 Arsenal St, Watertown, MA 02472-5091 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327611 | Adel Mostafavi, Md PC | Psychiatry & Neurology | 104 W 40th St Rm 400, New York, NY 10018-3692 | 2020-08-17 |
| 1023632015 | Child and Adult Clinical Psychiatry PC | Psychiatry & Neurology | 75 Prospect St Ste 110, Huntington, NY 11743-3320 | 2020-06-04 |
| 1598306441 | Place of Mind Child, Adolescent, and Adult Psychiatry P.C. | Psychiatry & Neurology | 240 Central Park S Apt 2h, New York, NY 10019-1435 | 2019-10-02 |
| 1881102267 | Park Avenue Physicians PC | Psychiatry & Neurology | 5 W 86th St Apt 1b, New York, NY 10024-3663 | 2018-01-19 |
| 1518478080 | Diego G. Calabria Physician P.C. | Psychiatry & Neurology | 366 N Broadway Ste 304, Jericho, NY 11753-2000 | 2017-10-23 |
| 1013426865 | Bebsy Estefan Md PC | Psychiatry & Neurology | 3050 Corlear Ave # Phb, Bronx, NY 10463-5180 | 2017-09-25 |
| 1902281629 | Derek Rudge | Psychiatry & Neurology | 1051 Riverside Dr Rm 235, New York, NY 10032-1007 | 2015-07-23 |
| 1275918096 | Dr Omar Bashayan Physician Pllc | Psychiatry & Neurology | 155 W 68th St Apt 1102, New York, NY 10023-5816 | 2015-07-22 |
| 1740676766 | Maura E Tappen | Psychiatry & Neurology | 1860 South Ave, Rochester, NY 14620-4229 | 2015-04-07 |
| 1194119560 | Krishen Persaud | Psychiatry & Neurology | Stony Brook Psychiatric Associates, Ufpc, Sbumc, Hsc Level 10, Rm.020, Stony Brook, NY 11794-8101 | 2015-03-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.