Broadway Mall Eye Care LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

BROADWAY MALL EYE CARE LLC

Practice address

358B Broadway Mall Ste 881
Hicksville, NY 11801-2709

Phone

(516) 938-6006

NPI assigned

Sep 10, 2020

Organization subpart

No

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

Authorized official

Name

Leonid Vayner

Title

Owner

Phone

(917) 748-1570

Specialties & licenses 1

Addresses

Other names 1

• STERLING OPTICAL Doing business as

Practitioners 2

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

• Elena Feldman, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1679526040
  NPD
• Jaswant Kaur, OD

  • Optometrist
  • Hicksville, NY
  • NPI 1922695550
  NPD (past)

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1053926683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358B BROADWAY MALL STE 881",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118012709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358B BROADWAY MALL STE 881",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118012709",
            "telephone_number": "516-938-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY MALL EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "VAYNER",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-748-1570"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STERLING OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Bravo
• Kiera Brennan, LMSW
• Kimberly Brennan
• Stacey Brites
• Broadway Mall Dental
• Broadway Mall Optical
• Broadway Mall Vision Express, LLC
• Abimbola Brooks
• Nicholas Edward Broughton, PHYSICIAN ASSISTANT
• Jazmen Brown

• Eyewear Supplier in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.