Organization Name: | LEVITTOWN CLINICAL CENTER PSC |
NPI Number: | 1093980658 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERTO MARTINEZ-SUAREZ (ADMINISTRATOR) |
Mailing Address: | Ave Los Dominicos Rh 8 Levittown |
State: | PR US |
Postal Code: | 00949 |
Phone Number: | 7879987462 |
Fax Number: | 7879987542 |
NPI Enumeration Date: | 04/24/2008 |
NPI Last Update Date: | 05/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |