Provider Demographics
NPI:1174827679
Name:SANDER J. LEVINSON, M.D. PC
Entity Type:Organization
Organization Name:SANDER J. LEVINSON, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDER
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-346-3934
Mailing Address - Street 1:746 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1624
Mailing Address - Country:US
Mailing Address - Phone:570-346-3934
Mailing Address - Fax:
Practice Address - Street 1:746 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1624
Practice Address - Country:US
Practice Address - Phone:570-346-3934
Practice Address - Fax:570-346-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011826E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty