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
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Gary Siegelbaum, O.D.NPI 1144301474
Title
President
Phone
(718) 454-8484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

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

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "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.