Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD420490 | PA |
NPI | 1063483469 |
---|---|
Provider Name | Dr. Claresa S Levetan |
First Address | Philadelphia, PA 19130 |
Second Address | Philadelphia, PA 19130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 01/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001940190 | (05) | PA |
232359401 | MAIN LINE HEALTHCARE (01) | PA |
D70540 | (02) |