National Provider Identifier

Jack Levine, O.D.

Jack Levine, O.D. is listed in the NPPES registry with a primary specialty of Optometrist in Buffalo, NY and a listed phone number of (716) 822-1515.

NPI 1912089814Buffalo, NYOptometrist

Profile Overview

NPI
1912089814
Provider Type
Individual
Primary Specialty
Optometrist
Enumeration Date
October 19, 2006
Last Updated
July 08, 2007

Practice Location

  • 2064 Seneca St
  • Buffalo, NY 14210-2343

Phone: (716) 822-1515

Mailing Address

  • 120 Meyer RD
  • #523
  • Buffalo, NY 14226-1046

Specialties

  • Optometrist (152W00000X)
Full Record
NPI
1912089814
Entity Type
Individual
Last Name
Levine
First Name
Jack
Name Prefix
Dr.
Credential
O.D.
Mailing Street Address
120 Meyer RD
Mailing Address Line 2
#523
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14226-1046
Mailing Country
US
Mailing Phone
(716) 834-6399
Practice Street Address
2064 Seneca St
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14210-2343
Practice Country
US
Practice Phone
(716) 822-1515
Enumeration Date
October 19, 2006
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optometrist (152W00000X)
Other Identifiers
00610619 (NY)