NPIMap

Organization Active NPI

Fresh Eyes Inc

  • Optometrist
  • Fresh Meadows, NY
National Provider Identifier
1043496367
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV43351 Issued in NY
Legal business name
FRESH EYES INC
Practice address
6130A 190TH St
Fresh Meadows, NY 11365-2721
Phone
(718) 454-8484
Fax
(718) 454-8910
NPI assigned
Jan 16, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Gary Siegelbaum, O.D.
Title
President
Phone
(718) 454-8484

Practitioners 16

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

View all 16

National Provider Directory

National Provider Directory

Locations

6130A 190th St
Fresh Meadows, NY 11365
Phone (718) 454-8484

6130 190th St
Ste A
Fresh Meadows, NY 11365
Phone (718) 454-8484

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV43351 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

6130A 190TH St
Fresh Meadows, NY 11365-2721

Mailing address

6130A 190TH St
Fresh Meadows, NY 11365-2721
Phone (718) 454-8484

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 16, 2008.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1043496367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130A 190TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652721",
            "telephone_number": "718-454-8484",
            "fax_number": "718-454-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130A 190TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652721",
            "telephone_number": "718-454-8484",
            "fax_number": "718-454-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH EYES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "SIEGELBAUM",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-454-8484",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV43351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.