Individual
DR. JON LIVELSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3326
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS017475
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2011
Last updated
06/16/2016
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