Provider Demographics
NPI:1508911439
Name:LAVSKY, ALBERT I (OD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:I
Last Name:LAVSKY
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 1:3319 MIDDLESEX DR
Mailing Address - Street 2:APT. A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1648
Mailing Address - Country:US
Mailing Address - Phone:419-531-6041
Mailing Address - Fax:
Practice Address - Street 1:3725 WILLISTON RD
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:NORTHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43619-2032
Practice Address - Country:US
Practice Address - Phone:419-693-0277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3546152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist