Provider Demographics
NPI:1679530075
Name:LEVINE, AMY B (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:1500 MARKET ST
Mailing Address - Street 2:24TH FLOOR WEST TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-255-3529
Mailing Address - Fax:215-832-2213
Practice Address - Street 1:216 N BROAD ST
Practice Address - Street 2:4TH FLOOR FEINSTEIN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1121
Practice Address - Country:US
Practice Address - Phone:215-762-4000
Practice Address - Fax:215-762-4323
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD050126L207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Not Answered207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA460475Medicare ID - Type Unspecified
PAF68755Medicare UPIN