Healthcare Provider Details

I. General information

NPI: 1265498620
Provider Name (Legal Business Name): LEV SKORODINSKY PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 LANGHORNE NEWTOWN RD
LANGHORNE PA
19047-1201
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 215-710-5900
  • Fax: 215-710-6973
Mailing address:
  • Phone: 215-710-6274
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA051189
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: