MEDICARE: DR. ROGER FARRELL LEVY D.C.

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	111NR0400X	Rehabilitation Chiropractor	DC-6420-L	PA

General Provider Information

NPI Number	:	1326171646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER FARRELL LEVY D.C.

Provider Business Mailing Address
First Line	:	1438 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-3936
Country	:	US
Telephone Number	:	215-271-6000
Fax Number	:	215-271-4115

Provider Business Practice Location Address
First Line	:	1438 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-3936
Country	:	US
Telephone Number	:	215-271-6000
Fax Number	:	215-271-4115

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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