Provider Demographics
NPI:1487651675
Name:LEVIN, NEIL (DO)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:239 HURFFVILLE CROSSKEYS RD STE 460
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4009
Practice Address - Country:US
Practice Address - Phone:856-341-8181
Practice Address - Fax:856-341-8180
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB33411207Q00000X
NJ25MB03341100208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMB33411OtherLICENSE NUMBER
AL7598848OtherDEA REGISTRATION
NJD02185200OtherCDS REGISTRATION