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General NPI Number Information
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NPI Number | 1053571240
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Entity Type | Individual
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Provider Name | PHILLIP R. LEVINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 39 WINDING WAY
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City | VERONA
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State | PA
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Zip | 15147-3886
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Country | US
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Telephone | 412-826-4822
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Fax | 412-963-9702
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Provider Business Mailing Address
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Address Line | 39 WINDING WAY
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City | VERONA
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State | PA
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Zip | 15147-3886
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Country | US
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Telephone | 412-826-4822
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Fax | 412-963-9702
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD026245L
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License Number State | PA
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