Healthcare Provider Details

I. General information

NPI: 1902065857
Provider Name (Legal Business Name): RACHEL SHOSHANA LEVENBACH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL SHOSHANA STERLING M.D.

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 YOUNG AVE STE 200
MOORESTOWN NJ
08057-3146
US

IV. Provider business mailing address

25 MAIN ST STE 601
HACKENSACK NJ
07601-7083
US

V. Phone/Fax

Practice location:
  • Phone: 609-702-1900
  • Fax:
Mailing address:
  • Phone: 856-912-7265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA09521700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT192988
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: