MEDICARE: DR. ERNEST V. LOEWENSTEIN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WV0400X	Vision Therapy Optometrist	2623	MA

General Provider Information

NPI Number	:	1205832359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST V. LOEWENSTEIN O.D.

Provider Business Mailing Address
First Line	:	471 WASHINGTON ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02458-1450
Country	:	US
Telephone Number	:	617-244-6454
Fax Number	:	617-965-3685

Provider Business Practice Location Address
First Line	:	471 WASHINGTON ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02458-1450
Country	:	US
Telephone Number	:	617-244-6454
Fax Number	:	617-965-3685

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	02/06/2012

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