Provider Demographics
NPI:1710977426
Name:LEVENBERG, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:LEVENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 COTTONWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1445 WHITEHORSE MERCERVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3834
Practice Address - Country:US
Practice Address - Phone:609-587-6661
Practice Address - Fax:609-587-8035
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024381E207R00000X
NJ25MA04030600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0563060OtherAETNA HEALTH PLAN
NJ0022026000OtherAMERIHEALTH/INDEPENDENCE
NJ1K3444OtherHEALTH NET
NJ2361302Medicaid
NJ11024747OtherHORIZON HEALTH PLAN
NJ2361302Medicaid
NJ110202910Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ2361302Medicaid