Provider Demographics
NPI:1336653336
Name:LEVY, EYAL SHLOMO (APN)
Entity Type:Individual
Prefix:
First Name:EYAL
Middle Name:SHLOMO
Last Name:LEVY
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 HORSHAM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1320
Mailing Address - Country:US
Mailing Address - Phone:215-371-2123
Mailing Address - Fax:
Practice Address - Street 1:12003 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-2152
Practice Address - Country:US
Practice Address - Phone:215-371-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018181363LF0000X
NJ26NJ00805500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily