Individual provider Active NPI

Trellanie Bouchard Sternberg

  • Optician
  • East Syracuse, NY
National Provider Identifier
1073303558
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
010601-01 Issued in NY
Practice address
6438 Basile Rowe
East Syracuse, NY 13057-3900
Phone
(315) 434-9168
Fax
(315) 434-9182
NPI assigned
May 8, 2025
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 010601-01 NY Primary

Addresses

Primary practice location

6438 Basile Rowe
East Syracuse, NY 13057-3900

Mailing address

6438 Basile Rowe
East Syracuse, NY 13057-3915
Phone (315) 434-9168

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
010601-01NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1073303558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6438 BASILE ROWE",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573915",
            "telephone_number": "315-434-9168",
            "fax_number": "315-434-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6438 BASILE ROWE",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573900",
            "telephone_number": "315-434-9168",
            "fax_number": "315-434-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERNBERG",
        "first_name": "TRELLANIE",
        "middle_name": "BOUCHARD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "010601-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.