Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00359700 | NJ |
NPI | 1013040328 |
---|---|
Provider Name | Dr. Stanley Ira Levinger |
First Address | Teaneck, NJ 07666-1713 |
Second Address | Teaneck, NJ 07666-1713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 16/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2704307 | (05) | NJ |
T77696 | (02) | NJ |