Woodside Vision Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WOODSIDE VISION INC

Practice address

5311 Broadway
Woodside, NY 11377-1730

Phone

(718) 255-1040

NPI assigned

Mar 12, 2020

Organization subpart

No

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

Authorized official

Name

Paola Jelena Burburan, OD

Title

Optometrist

Phone

(718) 255-1040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1083249809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 BROADWAY",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771730",
            "telephone_number": "718-255-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5311 BROADWAY",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771730",
            "telephone_number": "718-255-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSIDE VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "BURBURAN",
        "authorized_official_first_name": "PAOLA",
        "authorized_official_middle_name": "JELENA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "718-255-1040",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Woodside, NY
• Providers in Woodside, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.