| Doctor Name: | BERNARD P LEVINE |
| NPI Number: | 1144439225 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 35S100137600 |
| Business Practice Address: | 570 Lee St Perth Amboy, NJ - 088613053 |
| Business Phone Number: | 7324421666 |
| Business Fax Number: | |
| Mailing Address: | 10 Pheasant Run, EDISON |
| State: | NJ |
| Postal Code: | 088202900 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 35S100137600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |