Organization Active NPI

Setauket Optical

  • Durable Medical Equipment & Medical Supplies
  • Setauket, NY
National Provider Identifier
1073662342
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
005336-1 Issued in NY
Legal business name
SETAUKET OPTICAL
Practice address
1378 Route 25a
Setauket, NY 11733-2842
Phone
(631) 689-0001
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Frank Joseph Pollina, OPHTHALMIC DISPENSER
Title
President
Phone
(631) 689-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 005336-1 NY Primary

Addresses

Primary practice location

1378 Route 25a
Setauket, NY 11733-2842

Mailing address

1378 Route 25a
Setauket, NY 11733-2842
Phone (631) 689-0001

Other identifiers 1

IdentifierTypeStateIssuer
940223OtherNYEYEMED LOCATION NUMBER

National Provider Directory

National Provider Directory

Locations

1378 Route 25A
Setauket, NY 11733
Phone (631) 689-0001

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073662342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 ROUTE 25A",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332842",
            "telephone_number": "631-689-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 ROUTE 25A",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332842",
            "telephone_number": "631-689-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETAUKET OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLLINA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-689-0001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPHTHALMIC DISPENSER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "005336-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED LOCATION NUMBER",
            "identifier": "940223",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.