Provider Demographics
NPI:1104821842
Name:GIVNER, STEVEN (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:GIVNER
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 1:5221 LITTLE NECK PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1836
Mailing Address - Country:US
Mailing Address - Phone:718-281-1015
Mailing Address - Fax:718-281-1012
Practice Address - Street 1:5221 LITTLE NECK PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1836
Practice Address - Country:US
Practice Address - Phone:718-281-1015
Practice Address - Fax:718-281-1012
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004505-1152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
0970020OtherAETNA/US HEALTHCARE
NYC4445-1OtherEMPIRE BC/BS
P675646OtherOXFORD HEALTH PLANS
NY00936425Medicaid
NYC4445-3Medicare ID - Type UnspecifiedEMPIRE MEDICARE
NY00936425Medicaid
NY0891510001Medicare NSC
0970020OtherAETNA/US HEALTHCARE