Organization
ISL, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILAN S. LEVINSON MD (OWNER)
(570) 424-6187
Entity
Organization
Contact information
Practice address
1172 WEST MAIN STREET, STROUDSBURG, PA 18360
(570) 424-6187
(570) 424-6271
Mailing address
1172 WEST MAIN STREET, STROUDSBURG, PA 18360
(570) 424-6187
(570) 424-6271
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000479187
HIGHMARK BLUE SHIELD
PA
05
—
0016136970009
—
PA
Enumeration date
08/05/2006
Last updated
09/29/2015
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