Active NPI
Gary Eugene Wilcox, OPTICIAN
- Optician
- Lewiston, NY
National Provider Identifier
1083796759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 40541
- Practice address
- 900 Center Street
Lewiston, NY 14092-1737 - Phone
- (716) 754-2555
- Fax
- (716) 754-8650
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 40541 | NY | Primary |
Addresses
Primary practice location
900 Center Street
Lewiston, NY 14092-1737
Mailing address
900 Center St
Lewiston, NY 14092
Phone (716) 754-2555
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40541 | NY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083796759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 CENTER ST",
"city": "LEWISTON",
"state": "NY",
"postal_code": "14092",
"telephone_number": "716-754-2555",
"fax_number": "716-754-8650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 CENTER STREET",
"city": "LEWISTON",
"state": "NY",
"postal_code": "140921737",
"telephone_number": "716-754-2555",
"fax_number": "716-754-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "GARY",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "40541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.