MEDICARE: DR. DAVID E SAUSNER 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	152W00000X	Optometrist	TUV0047091	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	112035538	OTHER	NY	UNITED HEALTH CARE
2	P2042372	OTHER	NY	OXFORD
3	2C6560	OTHER	NY	HEALTHNET
4	493055	OTHER	NY	AETNA
5	C33481	OTHER	NY	EMPIRE BLUE CROSS BLUE SH

General Provider Information

NPI Number	:	1689665069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E SAUSNER O.D.

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1018 PARK BLVD
Second Line	:
City	:	MASSAPEQUA PARK
State	:	NY
Zip	:	11762-2711
Country	:	US
Telephone Number	:	516-798-9226
Fax Number	:	516-798-2087

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	01/31/2024

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