Provider Demographics
NPI:1336307016
Name:LEVINSON, STEPHANIE JOY (RD)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JOY
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 OLD YORK RD
Mailing Address - Street 2:MOBILE TOWN CENTER
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1427
Mailing Address - Country:US
Mailing Address - Phone:215-887-8787
Mailing Address - Fax:
Practice Address - Street 1:921 OLD YORK RD
Practice Address - Street 2:MOBILE TOWN CENTER
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-1427
Practice Address - Country:US
Practice Address - Phone:215-887-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002660133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered