Organization Active NPI

Jac Optical

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1073675252
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JAC OPTICAL
Practice address
262 Arden Ave
Staten Island, NY 10312-1219
Phone
(718) 356-3249
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Authorized official

Name
Mrs. Jeanine CamerlengoNPI 1578966446
Title
Owner
Phone
(718) 356-3249

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

262 Arden Ave
Staten Island, NY 10312-1219

Mailing address

262 Arden Ave
Staten Island, NY 10312-1219
Phone (718) 356-3249

Other identifiers 1

IdentifierTypeStateIssuer
02623063MedicaidNY

Other names 1

  • I'll Be Seeing You Doing business as

National Provider Directory

National Provider Directory

Locations

262 Arden Ave
#I
Staten Island, NY 10312
Phone (718) 356-3249

262 Arden Ave
Staten Island, NY 10312
Phone (718) 356-3249

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1073675252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 ARDEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121219",
            "telephone_number": "718-356-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 ARDEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121219",
            "telephone_number": "718-356-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "CAMERLENGO",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-356-3249",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02623063",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "I'll Be Seeing You",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.