Active NPI
Andrew M Cullen
- Optician
- Rosedale, NY
National Provider Identifier
1043494123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 006356-1
- Practice address
- 25301 Rockaway Blvd
Rosedale, NY 11422-3113 - Phone
- (516) 295-2135
- Fax
- (516) 295-4561
- NPI assigned
- Dec 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 006356-1 | NY | Primary |
Addresses
Primary practice location
25301 Rockaway Blvd
Rosedale, NY 11422-3113
Mailing address
25301 Rockaway Blvd
Rosedale, NY 11422-3113
Phone (516) 295-2135
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00724910 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006356-1 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198540800000",
"number": "1043494123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25301 ROCKAWAY BLVD",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114223113",
"telephone_number": "516-295-2135",
"fax_number": "516-295-4561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25301 ROCKAWAY BLVD",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114223113",
"telephone_number": "516-295-2135",
"fax_number": "516-295-4561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLEN",
"first_name": "ANDREW",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-25",
"last_updated": "2007-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "006356-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00724910",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.