Provider Demographics
NPI:1720428824
Name:LEVCHIK, SANJA (OD)
Entity Type:Individual
Prefix:MRS
First Name:SANJA
Middle Name:
Last Name:LEVCHIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:SANJA
Other - Middle Name:
Other - Last Name:LEVCHIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3133 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1521
Mailing Address - Country:US
Mailing Address - Phone:914-526-1110
Mailing Address - Fax:914-526-1112
Practice Address - Street 1:3133 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547-1521
Practice Address - Country:US
Practice Address - Phone:914-526-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00113800152W00000X
NYTUV008232-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist