MEDICARE: SUNSETCITY EYEWEAR

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	332B00000X	Durable Medical Equipment & Medical Supplies	0619690001	NY

General Provider Information

NPI Number	:	1851518559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSETCITY EYEWEAR

Provider Business Mailing Address
First Line	:	1148 DEER PARK AVE
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-3102
Country	:	US
Telephone Number	:	631-586-1777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1148 DEER PARK AVE
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-3102
Country	:	US
Telephone Number	:	631-586-1777
Fax Number	:

Authorized Official
Title or Position	:	O.D.
Name	:	DR. MICHAEL B LEVINSON
Credential	:
Telephone Number	:	631-242-0808

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	06/02/2014

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