Provider Demographics
NPI:1821268665
Name:NASSAU MEDICAL EYE CARE
Entity Type:Organization
Organization Name:NASSAU MEDICAL EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-665-7520
Mailing Address - Street 1:375 E MAIN ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8418
Mailing Address - Country:US
Mailing Address - Phone:631-665-1330
Mailing Address - Fax:631-665-1363
Practice Address - Street 1:4212 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5723
Practice Address - Country:US
Practice Address - Phone:631-731-6309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149082152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17494Medicare UPIN