Provider Demographics
NPI:1265449151
Name:LEVINE, JODI D (MD)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:D
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9232
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:701 E MARSHALL ST
Practice Address - Street 2:CHOP CARE NETWORK AT CHESTER COUNTY HOSPITAL
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4412
Practice Address - Country:US
Practice Address - Phone:610-431-5376
Practice Address - Fax:610-431-5527
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2013-04-18
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Provider Licenses
StateLicense IDTaxonomies
PAMD424137208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0083054Medicaid
PA101444318Medicaid
PA101444318Medicaid
NJ0083054Medicaid