Provider Demographics
NPI:1689665069
Name:SAUSNER, DAVID E (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:SAUSNER
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 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:
Practice Address - Street 1:1018 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2711
Practice Address - Country:US
Practice Address - Phone:516-798-9226
Practice Address - Fax:516-798-2087
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0047091152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY112035538OtherUNITED HEALTH CARE
NYP2042372OtherOXFORD
NY2C6560OtherHEALTHNET
NY493055OtherAETNA
NYC33481OtherEMPIRE BLUE CROSS BLUE SH
NYC33481Medicare ID - Type Unspecified