Provider Demographics
NPI:1154509107
Name:DAVID E SAUSNER, O.D.,PLLC
Entity Type:Organization
Organization Name:DAVID E SAUSNER, O.D.,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAUSNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-798-9226
Mailing Address - Street 1:1018 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-2711
Mailing Address - Country:US
Mailing Address - Phone:516-798-9226
Mailing Address - Fax:516-798-2087
Practice Address - Street 1:1018 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2711
Practice Address - Country:US
Practice Address - Phone:516-798-9226
Practice Address - Fax:516-798-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004709-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC33481Medicare PIN
NY5651530001Medicare NSC