Provider Demographics
NPI:1356373021
Name:LEVY, MAURICE (DPM)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 OLD YORK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2013
Mailing Address - Country:US
Mailing Address - Phone:215-675-1575
Mailing Address - Fax:215-682-7450
Practice Address - Street 1:1210 OLD YORK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2013
Practice Address - Country:US
Practice Address - Phone:215-675-1575
Practice Address - Fax:215-682-7450
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC1510-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0501883Medicaid
PAT72546Medicare UPIN
PA0501883Medicaid