Provider Demographics
NPI:1518401108
Name:LEV, BERBERICH, STABILE, DIRENZO LTD
Entity Type:Organization
Organization Name:LEV, BERBERICH, STABILE, DIRENZO LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-856-9989
Mailing Address - Street 1:8740 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2324
Mailing Address - Country:US
Mailing Address - Phone:330-856-9989
Mailing Address - Fax:
Practice Address - Street 1:8740 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2324
Practice Address - Country:US
Practice Address - Phone:330-856-9989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty