Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD441733 | PA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA09305600 | NJ |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD441733 | PA |
NPI | 1245558220 |
---|---|
Provider Name | Lisa D Levine |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Philadelphia, PA 19104-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 29/10/2020 |