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General NPI Number Information
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NPI Number | 1710439450
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Entity Type | Organization
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Legal Business Name | JONATHAN B LEVYN, DO-PC
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 3402 F ST
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1225
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Country | US
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Telephone | 215-634-5481
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Fax |
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Provider Business Mailing Address
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Address Line | 3402 F ST
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1225
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Country | US
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Telephone | 215-634-5481
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN B LEVYN
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Credential | D.O
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Telephone | 215-634-5481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | OA003971
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License Number State | PA
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