Healthcare Provider Details

I. General information

NPI: 1053680827
Provider Name (Legal Business Name): PHILADELPHIA HEALTH AND EDUCATION CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 A ST NELSON PAVILLION, 2ND FLOOR, FAMILY PLANNING
PHILADELPHIA PA
19134-1043
US

IV. Provider business mailing address

3601 A ST NELSON PAVILLION, 2ND FLOOR, FAMILY PLANNING
PHILADELPHIA PA
19134-1043
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-4871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD073928L
License Number StatePA

VIII. Authorized Official

Name: DR. LEONARD LEVINE
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 215-427-6694