Provider Demographics
NPI:1962594903
Name:BART, JASON M I (OD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:BART
Suffix:I
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 1:3697 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1316
Mailing Address - Country:US
Mailing Address - Phone:516-796-2020
Mailing Address - Fax:
Practice Address - Street 1:3697 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1316
Practice Address - Country:US
Practice Address - Phone:516-796-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2015-02-26
Deactivation Date:2007-02-13
Deactivation Code:
Reactivation Date:2007-03-29
Provider Licenses
StateLicense IDTaxonomies
NYTUV006342152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist