Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 25MA09138400 | NJ |
NPI | 1003191305 |
---|---|
Provider Name | Jodi Levy |
First Address | Camden, NJ 08103-1088 |
Second Address | Camden, NJ 08103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2011 |
Last Update Date | 28/05/2019 |