1306114731 NPI number — MRS. JULIA ALEXANDRA LEVIN DPT

Table of content: MRS. JULIA ALEXANDRA LEVIN DPT (NPI 1306114731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306114731 NPI number — MRS. JULIA ALEXANDRA LEVIN DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVIN
Provider First Name:
JULIA
Provider Middle Name:
ALEXANDRA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KRINSKY
Provider Other First Name:
JULIA
Provider Other Middle Name:
ALEXANDRA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306114731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1753 FOXWOOD DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JAMISON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18929
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-265-4440
Provider Business Mailing Address Fax Number:
215-947-4141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 GREEN LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRISTOE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-826-0166
Provider Business Practice Location Address Fax Number:
215-947-4141
Provider Enumeration Date:
12/13/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT021766 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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