Main Optical LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

License

009250 Issued in NY

Legal business name

MAIN OPTICAL LLC

Doing business as

Main Optical

Practice address

6830 Main St
Flushing, NY 11367-1325

Phone

(718) 575-3937

Fax

(718) 261-2191

NPI assigned

May 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eduard Borukhov

Title

Owner

Phone

(347) 642-2593

Specialties & licenses 1

Addresses

Other names 1

• Main Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Wallach, OD

  • Optometrist
  • Jamaica, NY
  • NPI 1972717544
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1003176603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671325",
            "telephone_number": "718-575-3937",
            "fax_number": "718-261-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671325",
            "telephone_number": "718-575-3937",
            "fax_number": "718-261-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "BORUKHOV",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-642-2593"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Main Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omar Mahboob
• Geissa Nyn Mahilum
• Freeza Mahmood, PA-C
• Leslie Mai
• Main Care Pharmacy Inc
• Main Pharmacy Inc.
• Main Point RX LLC
• Main RX Inc.
• Main St Acupuncture PC
• Main Street Diagnostic Inc

• Optician in Flushing, NY
• Providers in Flushing, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.