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General NPI Number Information
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NPI Number | 1710068184
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Entity Type | Individual
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Provider Name | LISA ROSEMOND LEVINE OD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1665 STATE HILL RD
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City | WYOMISSING
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State | PA
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Zip | 19610-1900
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Country | US
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Telephone | 610-373-2830
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Fax | 610-655-8805
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Provider Business Mailing Address
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Address Line | 31 FLINT RIDGE DR
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City | SHILLINGTON
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State | PA
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Zip | 19607-3016
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Country | US
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Telephone | 610-775-1241
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001381
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License Number State | PA
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