Provider Demographics
NPI:1265498620
Name:SKORODINSKY, LEV (PA)
Entity Type:Individual
Prefix:
First Name:LEV
Middle Name:
Last Name:SKORODINSKY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-6274
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1201 LANGHORNE NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1201
Practice Address - Country:US
Practice Address - Phone:215-710-5900
Practice Address - Fax:215-710-6973
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051189363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q10546Medicare UPIN
PA077234Medicare ID - Type Unspecified