Provider Demographics
NPI:1497817068
Name:LEVY, ALAN L (OD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:LEVY
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 1:932 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2522
Mailing Address - Country:US
Mailing Address - Phone:516-437-2120
Mailing Address - Fax:516-437-3075
Practice Address - Street 1:932 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2522
Practice Address - Country:US
Practice Address - Phone:516-437-2120
Practice Address - Fax:516-437-3075
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT3654152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist