Organization
PHOENIX OB GYN ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD TEDDY LEVINE M.D. (MANAGER)
(609) 261-6701
Entity
Organization
Contact information
Practice address
120 MADISON AVE, SUITE B, MOUNT HOLLY, NJ 08060-2055
(609) 261-4925
(609) 261-9362
Mailing address
120 MADISON AVE, SUITE B, MOUNT HOLLY, NJ 08060-2055
(609) 261-4925
(609) 261-9362
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135505000
AMERIHEALTH HMO
NJ
Enumeration date
06/23/2006
Last updated
08/22/2020
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