Organization Active NPI

Evan David Opticians

  • Eyewear Supplier
  • Woodhaven, NY
National Provider Identifier
1093770463
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EVAN DAVID OPTICIANS
Practice address
9008 Jamaica Ave
Woodhaven, NY 11421-2103
Phone
(718) 805-2020
Fax
(718) 805-2020
NPI assigned
Apr 19, 2006
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. Evan Romaine, OPTICIANNPI 1407811300
Title
Ceo
Phone
(718) 805-2020

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
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

9008 Jamaica Ave
Woodhaven, NY 11421-2103

Mailing address

9008 Jamaica Ave
Woodhaven, NY 11421-2103
Phone (718) 805-2020

Other identifiers 1

IdentifierTypeStateIssuer
01615012MedicaidNY

National Provider Directory

National Provider Directory

Locations

9008 Jamaica Ave
Woodhaven, NY 11421
Phone (718) 805-2020

Practitioners & affiliated clinicians

Practitioners 4

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": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093770463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9008 JAMAICA AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212103",
            "telephone_number": "718-805-2020",
            "fax_number": "718-805-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9008 JAMAICA AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212103",
            "telephone_number": "718-805-2020",
            "fax_number": "718-805-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN DAVID OPTICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROMAINE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-805-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01615012",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, 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.