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Individual

KENNETH BENSON LEVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
279 CAMBRIDGE STREET # 4, BURLINGTON EYE CARE, BURLINGTON, MA 01803
(781) 272-7733
(781) 272-5740
Mailing address
279 CAMBRIDGE STREET # 4, BURLINGTON EYE CARE, BURLINGTON, MA 01803
(781) 272-7733
(781) 272-5740

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
2745
MA
152W00000X
Optometrist
Primary
MA2745
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0336009
MA
01
04-2677792
UNITED HEALTHCARE INS
MA
05
110108180A
MA
01
56190
OPTICARE
MA
01
9281808
PHCS
MA
01
AS78783190001
CIGNA HEALTH CARE
MA
01
MA2745
AETNA
MA
01
W16224
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/31/2006
Last updated
07/17/2018
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