Provider Demographics
NPI:1689701963
Name:BURSTEIN, JAY L (OD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:L
Last Name:BURSTEIN
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:PO BOX 1445
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-0159
Mailing Address - Country:US
Mailing Address - Phone:215-348-5921
Mailing Address - Fax:
Practice Address - Street 1:424 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3404
Practice Address - Country:US
Practice Address - Phone:215-348-5921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE004869T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist