Provider Demographics
NPI:1134114366
Name:LEVINE, BARRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 N. HIGHLAND ROAD
Mailing Address - Street 2:SUITE G-101
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241
Mailing Address - Country:US
Mailing Address - Phone:412-854-1340
Mailing Address - Fax:412-854-1366
Practice Address - Street 1:1738 N HIGHLAND RD
Practice Address - Street 2:SUITE G-101
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1200
Practice Address - Country:US
Practice Address - Phone:412-854-1340
Practice Address - Fax:412-854-1366
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040012E2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012102540003Medicaid
PA531522Medicare ID - Type Unspecified
PA0012102540003Medicaid