| Isl, Ltd | |
|
1172 West Main Street Stroudsburg PA 18360 | |
| (570) 424-6187 | |
| (570) 424-6271 |
| Full Name | Isl, Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1172 West Main Street, Stroudsburg, Pennsylvania |
| Authorized Official Name and Position | Ilan S. Levinson (OWNER) |
| Authorized Official Contact | 5704246187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Isl, Ltd 1172 West Main Street Stroudsburg PA 18360 Ph: (570) 424-6187 | Isl, Ltd 1172 West Main Street Stroudsburg PA 18360 Ph: (570) 424-6187 |
| NPI Number | 1770592370 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 09/29/2015 |
| Medicare PECOS PAC ID | 4587565734 |
|---|---|
| Medicare Enrollment ID | O20040120000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770592370 | NPI | - | NPPES |
| 0016136970009 | Medicaid | PA | |
| 0000479187 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ilan S Levinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982625000 PECOS PAC ID: 5294636452 Enrollment ID: I20091120000239 |
| Provider Name | Lula D Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245668177 PECOS PAC ID: 7911135157 Enrollment ID: I20140114001323 |
| Provider Name | Amanda L Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821532276 PECOS PAC ID: 6709163728 Enrollment ID: I20170501000602 |
| Provider Name | Adam R Reish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891279659 PECOS PAC ID: 1951645225 Enrollment ID: I20181128001124 |
| Provider Name | Matthew D Ottinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174172563 PECOS PAC ID: 0345672994 Enrollment ID: I20191120000038 |
| Provider Name | Frank Golden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033704051 PECOS PAC ID: 5193132595 Enrollment ID: I20210331002981 |
| Provider Name | Sarah Fino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689393878 PECOS PAC ID: 3678959111 Enrollment ID: I20221006000687 |
| Provider Name | Rebecca A Dietterich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689457517 PECOS PAC ID: 7214382100 Enrollment ID: I20231012002026 |
| Provider Name | Alyssa M Hagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649044629 PECOS PAC ID: 0143670786 Enrollment ID: I20231222001893 |
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