Provider Demographics
NPI:1285652149
Name:LEVIN, JOSEPH BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRUCE
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:714 EAST MAIN ST
Practice Address - Street 2:STE 1C
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3068
Practice Address - Country:US
Practice Address - Phone:856-778-4009
Practice Address - Fax:856-778-4014
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA38811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E60096Medicare UPIN
077356 SK3Medicare PIN
631952Medicare PIN