Provider Demographics
NPI:1568645950
Name:LEBOVIC, DANIEL JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JACOB
Last Name:LEBOVIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1203 LANGHORNE NEWTOWN RD STE 135
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1212
Mailing Address - Country:US
Mailing Address - Phone:215-750-5050
Mailing Address - Fax:215-750-6514
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD STE 135
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1212
Practice Address - Country:US
Practice Address - Phone:215-750-5050
Practice Address - Fax:215-750-6514
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242539207R00000X
FLME100598207RH0003X
PAMD442201207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBC650ZMedicare PIN