MEDICARE: DR. CATHY J LEVIN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DSO23547L	PA

General Provider Information

NPI Number	:	1285720599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHY J LEVIN DMD

Provider Business Mailing Address
First Line	:	255 S 17TH ST
Second Line	:	SUITE 2507
City	:	PHILA
State	:	PA
Zip	:	19103-6231
Country	:	US
Telephone Number	:	215-545-4024
Fax Number	:	215-545-6288

Provider Business Practice Location Address
First Line	:	255 S 17TH ST
Second Line	:	SUITE 2507
City	:	PHILA
State	:	PA
Zip	:	19103-6231
Country	:	US
Telephone Number	:	215-545-4024
Fax Number	:	215-545-6288

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/27/2014

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