Healthcare Provider Details

I. General information

NPI: 1740283035
Provider Name (Legal Business Name): RICHARD LEVI MORGANSTEIN O. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5618 BERGENLINE AVE
WEST NEW YORK NJ
07093-1232
US

IV. Provider business mailing address

5618 BERGENLINE AVE
WEST NEW YORK NJ
07093-1232
US

V. Phone/Fax

Practice location:
  • Phone: 201-867-2942
  • Fax: 201-867-1777
Mailing address:
  • Phone: 201-867-2942
  • Fax: 201-867-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOA5282/TO576
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: