Provider Demographics
NPI:1164555959
Name:BURSTEIN, ALLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:BURSTEIN
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 1:14 CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6112
Mailing Address - Country:US
Mailing Address - Phone:516-364-2743
Mailing Address - Fax:
Practice Address - Street 1:3543 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1314
Practice Address - Country:US
Practice Address - Phone:516-731-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT003244-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT003244-1OtherNEW YORK STATE LICENSE