Provider Demographics
NPI:1396033221
Name:STEPHANIE LEVINSON, RD, LDN,PC
Entity Type:Organization
Organization Name:STEPHANIE LEVINSON, RD, LDN,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:215-906-4686
Mailing Address - Street 1:105 INVERRARY DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 INVERRARY DR
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3253
Practice Address - Country:US
Practice Address - Phone:215-906-4686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002660133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9329323OtherAETNA
PA2100197OtherFEDERAL HIGHMARK
PA1336307016OtherINDEPENDENCE BLUE CROSS
PA1437384211OtherFEDERAL HIGHMARK
PA3527373000OtherINDEPENDENCE BLUE CROSS
PA6888412OtherAETNA