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Individual

DR. DARRYL I LEVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2139 COTTMAN AVE, PHILADELPHIA, PA 19149-1122
(215) 745-1444
(215) 745-1448
Mailing address
2139 COTTMAN AVE, PHILADELPHIA, PA 19149-1122
(215) 745-1444
(215) 745-1448

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000266
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000266
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00640312
PA
01
2193348000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
06/06/2006
Last updated
02/23/2012
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