MEDICARE: DR. STEVEN R LEVY OD

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	VUT4679	NY
2	146N00000X	Basic Emergency Medical Technician	320607	NY

General Provider Information

NPI Number	:	1891791018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN R LEVY OD

Provider Business Mailing Address
First Line	:	21411A 73RD AVE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2947
Country	:	US
Telephone Number	:	718-225-5533
Fax Number	:	718-225-5803

Provider Business Practice Location Address
First Line	:	21411A 73RD AVE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2947
Country	:	US
Telephone Number	:	718-225-5533
Fax Number	:	718-225-5803

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	12/15/2009

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