Active NPI
Jennifer Megan Ceonzo, O.D.
- Optometrist
- Melville, NY
National Provider Identifier
1063509925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV006541
- Practice address
- 150 Broadhollow Rd Ste 104
Melville, NY 11747-4901 - Phone
- (631) 791-5155
- Fax
- (631) 791-5154
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV006541 | NY | Primary |
Addresses
Primary practice location
150 Broadhollow Rd Ste 104
Melville, NY 11747-4901
Mailing address
5 Windsor PL
Melville, NY 11747-1331
Phone (631) 673-1950
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV006541 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Island Optometric Vision Development, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Vision Therapy Optometrist
- Westbury, NY
- NPI 1013186402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1063509925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 WINDSOR PL",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117471331",
"telephone_number": "631-673-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 BROADHOLLOW RD STE 104",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117474901",
"telephone_number": "631-791-5155",
"fax_number": "631-791-5154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEONZO",
"first_name": "JENNIFER",
"middle_name": "MEGAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV006541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.