MEDICARE: DR. HOWARD R LEVY D.O.

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	207Q00000X	Family Medicine Physician	OS002557L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306966361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD R LEVY D.O.

Provider Business Mailing Address
First Line	:	5965 CHESTER AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19143-5517
Country	:	US
Telephone Number	:	215-727-2442
Fax Number	:	215-727-8070

Provider Business Practice Location Address
First Line	:	5965 CHESTER AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19143-5517
Country	:	US
Telephone Number	:	215-727-2442
Fax Number	:	215-727-8070

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/08/2007

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