Individual
ILAN S LEVINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
MD01855L
PA
2084P0800X
Psychiatry Physician
MD055185L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000789615
HIGHMARK
PA
05
—
0015426100005
—
PA
05
—
001542610000S
—
PA
Enumeration date
07/22/2006
Last updated
10/15/2015
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