Provider Demographics
NPI:1659516144
Name:LEVY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:LEVY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-727-2442
Mailing Address - Street 1:5965 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-5517
Mailing Address - Country:US
Mailing Address - Phone:215-727-2442
Mailing Address - Fax:215-727-8070
Practice Address - Street 1:5965 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-5517
Practice Address - Country:US
Practice Address - Phone:215-727-2442
Practice Address - Fax:215-727-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002557L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA041893Medicare PIN