Bonafide Opticians of Ave L Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

005083-1 Issued in NY

Legal business name

BONAFIDE OPTICIANS OF AVE L INC

Practice address

9508 Avenue L
Brooklyn, NY 11236-4811

Phone

(718) 444-3126

Fax

(718) 444-3126

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Iqbal Venjara, OPHTHALMIC DISPENSERNPI 1316970023

Title

Manager

Phone

(718) 444-3126

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bonafide Opticians Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Eli David Kassin, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1699824920
  Medicare reassignment NPD
• Iqbal Venjara, OPHTHALMIC DISPENSER

  • Ophthalmic Technician/Technologist
  • Brooklyn, NY
  • NPI 1316970023
  NPD Authorized official

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1083647705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9508 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364811",
            "telephone_number": "718-444-3126",
            "fax_number": "718-444-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9508 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364811",
            "telephone_number": "718-444-3126",
            "fax_number": "718-444-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONAFIDE OPTICIANS OF AVE L INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "VENJARA",
        "authorized_official_first_name": "IQBAL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-444-3126",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPHTHALMIC DISPENSER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "005083-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01501440",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonafide Opticians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olga Bomko
• Naomi Bomrind, MA
• Bon Appetite Ny Inc
• Clare Bonafede, MS ED
• Bonafide Acupuncture
• Paula Bonanni, R.N.
• Ernest Bonaparte, PH.D.
• Jose Bonaparte, LCSW-R
• Tagie Bonasse
• Claudette Derival Bonaventure

• Durable Medical Equipment & Medical Supplies in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.