Healthcare Provider Details

I. General information

NPI: 1013186402
Provider Name (Legal Business Name): LONG ISLAND OPTOMETRIC VISION DEVELOPMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 POST AVENUE SUITE 380
WESTBURY NY
11590-2233
US

IV. Provider business mailing address

265 POST AVE SUITE 380
WESTBURY NY
11590-2233
US

V. Phone/Fax

Practice location:
  • Phone: 516-334-9385
  • Fax:
Mailing address:
  • Phone: 516-334-9385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberTUV005207
License Number StateNY

VIII. Authorized Official

Name: DR. MICHELE ROBIN BESSLER
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 516-334-9385