Provider Demographics
NPI:1861495517
Name:LEVY, ROBERT DEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DEAN
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 1:4423 ROUTE 130 S
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2385
Mailing Address - Country:US
Mailing Address - Phone:609-386-0202
Mailing Address - Fax:609-386-5927
Practice Address - Street 1:4423 ROUTE 130 S
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2385
Practice Address - Country:US
Practice Address - Phone:609-386-0202
Practice Address - Fax:609-386-5927
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5264152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist