1528170180 NPI number — DR. VICTORIA A LEVIN MD

Table of content: DR. VICTORIA A LEVIN MD (NPI 1528170180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528170180 NPI number — DR. VICTORIA A LEVIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVIN
Provider First Name:
VICTORIA
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1528170180
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4735 OGLETOWN STANTON RD
Provider Second Line Business Mailing Address:
MAP 2 SUITE 1116
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-2072
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-368-8653
Provider Business Mailing Address Fax Number:
302-368-8836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4735 OGLETOWN STANTON RD
Provider Second Line Business Practice Location Address:
MAP 2 SUITE 1116
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-2072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-368-8653
Provider Business Practice Location Address Fax Number:
302-368-8836
Provider Enumeration Date:
08/31/2006

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: 208000000X , with the licence number:  C1-0003698 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000328501 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4254170 . This is a "AETNA USHC" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 856325 . This is a "MAMSI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 0236775000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 45428 . This is a "COVENTRY" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 464890 . This is a "AMERIHEALTH PPO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: (0000)558701 . This is a "DIAMOND STATE PARTNERS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 0000328501 . This is a "DPCI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 510110041 . This is a "BCBS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 783F26 . This is a "BCBS DE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: K899 . This is a "BCBS MD" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 0236775000 . This is a "KEYSTONE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: G45882 . This is a "MIDATLANTIC" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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