Provider Demographics
NPI:1962688069
Name:STANLEY I LEVINGER OD PA
Entity Type:Organization
Organization Name:STANLEY I LEVINGER OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEVINGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-836-5644
Mailing Address - Street 1:502B CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1713
Mailing Address - Country:US
Mailing Address - Phone:201-836-5644
Mailing Address - Fax:
Practice Address - Street 1:502B CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1713
Practice Address - Country:US
Practice Address - Phone:201-836-5644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00359700332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ235437Medicare PIN
NJ0679790001Medicare NSC