NPIMap

Organization Active NPI

Watertown Medical Optical PLLC

  • Eyewear Supplier
  • Ogdensburg, NY
National Provider Identifier
1073076725
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WATERTOWN MEDICAL OPTICAL PLLC
Practice address
420 Ford St
Ogdensburg, NY 13669-1620
Phone
(315) 393-7171
Fax
(315) 393-2382
NPI assigned
Apr 10, 2019
Last updated
Apr 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Mrs. Doris PrashawNPI 1003158692
Title
Optical Manager
Phone
(315) 393-7171

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

420 Ford St
Ogdensburg, NY 13669-1620

Mailing address

420 Ford St
Ogdensburg, NY 13669-1620
Phone (315) 393-7171

Other names 1

  • NOAMAN SANNI Other name

National Provider Directory

National Provider Directory
Tax ID family
Watertown Medical Optical PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

420 Ford St
Ogdensburg, NY 13669
Phone (315) 393-7171

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1073076725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691620",
            "telephone_number": "315-393-7171",
            "fax_number": "315-393-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691620",
            "telephone_number": "315-393-7171",
            "fax_number": "315-393-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN MEDICAL OPTICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "PRASHAW",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "OPTICAL MANAGER",
        "authorized_official_telephone_number": "315-393-7171",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOAMAN SANNI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ogdensburg, NY

Sources for this page

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

Verify at the official NPI Registry.