NPIMap

Organization Active NPI

Long Island Eye Surgical Care, PC

  • Ophthalmology Physician
  • Brentwood, NY
National Provider Identifier
1013006576
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
070905000543 Issued in NY
Legal business name
LONG ISLAND EYE SURGICAL CARE, PC
Practice address
601 Suffolk Ave
Brentwood, NY 11717-4309
Phone
(631) 231-4455
Fax
(631) 257-5098
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jennifer Farruggio
Title
Credentialing Specialist
Phone
(631) 231-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 070905000543 NY Primary

Addresses

Primary practice location

601 Suffolk Ave
Brentwood, NY 11717-4309

Mailing address

601 Suffolk Ave
Brentwood, NY 11717-4309
Phone (631) 612-2724

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

375 E Main St
Ste 24
Bay Shore, NY 11706
Phone (631) 665-1330

110 Marcus Blvd
Ste 400
Hauppauge, NY 11788
Phone (631) 612-2770

640 Belle Terre Rd
Bldg G
Prt Jefferson, NY 11777
Phone (631) 331-1414

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013006576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SUFFOLK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174309",
            "telephone_number": "631-612-2724",
            "fax_number": "631-231-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SUFFOLK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174309",
            "telephone_number": "631-231-4455",
            "fax_number": "631-257-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND EYE SURGICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FARRUGGIO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "631-231-4455"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "070905000543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.