Provider Demographics
NPI:1154309177
Name:RESSEL, STEVEN B (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:RESSEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3036
Mailing Address - Country:US
Mailing Address - Phone:516-932-7299
Mailing Address - Fax:516-433-8785
Practice Address - Street 1:536 ROUTE 111
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4346
Practice Address - Country:US
Practice Address - Phone:631-265-4700
Practice Address - Fax:631-265-4749
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT 004324-1152W00000X
NYVUT 004321-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00789639Medicaid
NY00789639Medicaid
1173560001Medicare ID - Type UnspecifiedHEALTH NOW NY--DMERC A
NYC44521Medicare ID - Type UnspecifiedEMPIRE MEDICARE
U03082Medicare UPIN