Provider Demographics
NPI:1346692324
Name:MAZNIKER, LEV (OD)
Entity Type:Individual
Prefix:DR
First Name:LEV
Middle Name:
Last Name:MAZNIKER
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 1:2740 CROPSEY AVE
Mailing Address - Street 2:APT 14A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6849
Mailing Address - Country:US
Mailing Address - Phone:917-454-8843
Mailing Address - Fax:
Practice Address - Street 1:922A FLATBUSH AVE # L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4018
Practice Address - Country:US
Practice Address - Phone:718-862-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008490152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist