MEDICARE: DR. ERWIN KENNETH LEVIN PH.D.

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	103TC0700X	Clinical Psychologist	PS004384L	PA

General Provider Information

NPI Number	:	1548334030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERWIN KENNETH LEVIN PH.D.

Provider Business Mailing Address
First Line	:	552 N NEVILLE ST
Second Line	:	SUITE A
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-2855
Country	:	US
Telephone Number	:	412-682-5531
Fax Number	:	412-682-5587

Provider Business Practice Location Address
First Line	:	552 N NEVILLE ST
Second Line	:	SUITE A
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-2855
Country	:	US
Telephone Number	:	412-682-5531
Fax Number	:	412-682-5587

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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