Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD427051 | PA |
NPI | 1013954668 |
---|---|
Provider Name | Martha P Levine |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 10/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013947080001 | (05) | PA |
F204989 | (02) |