Basic Information
| Provider Information | |||||||||
| NPI: | 1366494296 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVINSTEIN | ||||||||
| FirstName: | GENE | ||||||||
| MiddleName: | V. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 STATESMAN RD | ||||||||
| Address2: | |||||||||
| City: | CHALFONT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189143581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156888967 | ||||||||
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| Practice Location | |||||||||
| Address1: | 451 W CHEW ST | ||||||||
| Address2: | SUITE 405 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181023472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107764746 | ||||||||
| FaxNumber: | 6107703452 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 02/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | MD425455 | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 208100000X | MD425455 | PA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 1016843320001 | 05 | PA | MEDICAID |