Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS042859 | PA |
NPI | 1164023800 |
---|---|
Provider Name | Dr. Nasim Levin |
First Address | Havertown, PA 19083-5536 |
Second Address | Philadelphia, PA 19104-6030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2020 |
Last Update Date | 07/11/2020 |