Tracking Details - #1193
Tracking Information
Case No: 1104
Order Date:
12/03/2025
Due Date:
—
Template Packet: HIPAA Authorization Packet
Scope:
—
Location: Adrienne Levy, MD
989 Jericho Turnpike
Smithtown, NY 11787
Phone: (631) 864-7100
• Fax: (631) 864-7129
Patient: Taylor Swift
DOB: 12/25/2000
• SSN: ***-**-8420
Requested Records
| Record | Status |
|---|---|
| Billing | Pending |
| File Name | Uploaded Date | Uploaded By |
|---|---|---|
| NextDocument_20251203173500647.pdf | 2025-12-03 |
Tracking Step Log
| Step | Due Date | Remarks | Publish | Entered |
|---|---|---|---|---|
| Received Order, In Progress | Yes | 12/3/2025 12:35 PM |
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