Provider Demographics
NPI:1497979108
Name:LEVY, LAWRENCE M (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:M
Last Name:LEVY
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:414 SALFORD STATION
Mailing Address - City:SALFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18957-0117
Mailing Address - Country:US
Mailing Address - Phone:610-584-7750
Mailing Address - Fax:610-584-7700
Practice Address - Street 1:2750 MORRIS RD.
Practice Address - Street 2:VISTEON NORTH PENN MEDICAL DEPARTMENT
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-6060
Practice Address - Country:US
Practice Address - Phone:610-584-7750
Practice Address - Fax:610-584-7700
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-004117-L2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE79670Medicare UPIN