5623 Nyc Optical LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

5623 NYC OPTICAL LLC

Practice address

5623 5TH Ave
Brooklyn, NY 11220-3414

Phone

(718) 635-9333

Fax

(718) 765-1113

NPI assigned

Jan 29, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Elena Pak

Title

Manager

Phone

(929) 924-6019

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1043072770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203414",
            "telephone_number": "718-635-9333",
            "fax_number": "718-765-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203414",
            "telephone_number": "718-635-9333",
            "fax_number": "718-765-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5623 NYC OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "929-924-6019",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.