1396033221 NPI number — STEPHANIE LEVINSON, RD, LDN,PC

Table of content: (NPI 1396033221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396033221 NPI number — STEPHANIE LEVINSON, RD, LDN,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHANIE LEVINSON, RD, LDN,PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396033221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 INVERRARY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE BELL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19422-3253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 INVERRARY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE BELL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19422-3253
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-906-4686
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
LEVINSON
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
JOY
Authorized Official Title or Position:
REGISTERED DIETITIAN
Authorized Official Telephone Number:
215-906-4686

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  DN002660 , 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)

  • Identifier: 9329323 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2100197 . This is a "FEDERAL HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1336307016 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1437384211 . This is a "FEDERAL HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3527373000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6888412 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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