Active NPI
John Deconno
- Optician
- Glenville, NY
National Provider Identifier
1073332847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 006734
- Practice address
- 200 Dutch Meadows Lane
Glenville, NY 12302 - Phone
- (518) 344-7634
- NPI assigned
- Oct 8, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 006734 | NY | Primary |
Addresses
Primary practice location
200 Dutch Meadows Lane
Glenville, NY 12302
Mailing address
200 Dutch Meadows Lane
Glenville, NY 12302
Phone (518) 344-7634
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1073332847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 DUTCH MEADOWS LANE",
"city": "GLENVILLE",
"state": "NY",
"postal_code": "12302",
"telephone_number": "518-344-7634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 DUTCH MEADOWS LANE",
"city": "GLENVILLE",
"state": "NY",
"postal_code": "12302",
"telephone_number": "518-344-7634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECONNO",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-08",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "006734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.