Julietta Mullokandova, OPTHALMIC DISPENSER

Primary specialty

OpticianTaxonomy code 156FX1800X

License

0997-01 Issued in NY

Practice address

2445 Arthur Ave
Bronx, NY 10458-6003

Phone

(917) 473-6699

Fax

(917) 473-6697

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glamour Ophthalmic Dispensing PC

  • Optician
  • Bronx, NY
  • NPI 1295338291
  NPD Authorized official

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1023615564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10540 62ND RD APT 1M",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751119",
            "telephone_number": "646-920-0062",
            "fax_number": "917-473-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 ARTHUR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104586003",
            "telephone_number": "917-473-6699",
            "fax_number": "917-473-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLOKANDOVA",
        "first_name": "JULIETTA",
        "credential": "OPTHALMIC DISPENSER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "0997-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverley Ann-Marie Mullings-Waite, MSW
• Katherine Petrick Mullins, MD
• Michelle Lynnette Mullins, L.C.S.W.
• Daniel Mullokandov, DDS
• Daniella Mullokandov, D.O.
• Jasjit Singh Multani, MD
• Multi Assistance Resource Centers Inc.
• Multi Medic Physician Services PC
• Multi-Specialty Pain Management, PC
• Multimedic Medical Services PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.