Individual
JACK LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3998 RED LION RD, PHILADELPHIA, PA 19114-1436
(215) 612-4000
(215) 612-4532
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD026169L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009132400007
—
PA
05
—
0009132400008
—
PA
05
—
0009132400013
—
PA
01
—
0058566000
KEYSTONE IBC
PA
01
—
00913240-02
AMERICHOICE - FRANKFORD
PA
01
—
00913240-03
AMERICHOICE - BUCKS
PA
01
—
00913240-04
AMERICHOICE - TORRES
PA
01
—
0144152
CIGNA
PA
01
—
07645
HEALTH PARTNERS
PA
01
—
080059643
RAILROAD MEDICARE
PA
01
—
1090642
KEYSTONE MERCY
PA
01
—
20029908
AMERIHEALTH MERCY
PA
01
—
429318
HIGHMARK BLUE SHIELD
PA
01
—
452729
AETNA CONTRACT
PA
01
—
PA0050405
TRICARE
PA
Enumeration date
07/17/2006
Last updated
11/23/2010
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