Provider Demographics
NPI:1205832359
Name:LOEWENSTEIN, ERNEST V (OD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:V
Last Name:LOEWENSTEIN
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 1:471 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1450
Mailing Address - Country:US
Mailing Address - Phone:617-244-6454
Mailing Address - Fax:617-965-3685
Practice Address - Street 1:471 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1450
Practice Address - Country:US
Practice Address - Phone:617-244-6454
Practice Address - Fax:617-965-3685
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2623152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17365801Medicare PIN
T59256Medicare UPIN