Provider Demographics
NPI:1770931107
Name:ONYANGO, LEVY (MD)
Entity type:Individual
Prefix:
First Name:LEVY
Middle Name:
Last Name:ONYANGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LEVY
Other - Middle Name:
Other - Last Name:ONYANGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:3ND FL RADIOLOGY DEPARTMENT
Mailing Address - City:PHILLADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:267-425-9254
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:267-425-9254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4774522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology