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General NPI Number Information
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NPI Number | 1063610558
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Entity Type | Individual
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Provider Name | ALICIA ANNE LEVIN PICARD MD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 100 E LANCASTER AVE LANKENAU HOSPITAL RADIOLOGY DEPT
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City | WYNNEWOOD
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State | PA
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Zip | 19096-3450
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Country | US
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Telephone | 610-429-0693
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Fax | 610-429-9048
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Provider Business Mailing Address
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Address Line | 100 E LANCASTER AVE LANKENAU HOSPITAL RADIOLOGY DEPT
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City | WYNNEWOOD
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State | PA
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Zip | 19096-3450
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Country | US
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Telephone | 610-429-0693
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Fax | 610-429-9048
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MT190667
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD445271
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License Number State | PA
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