Organization Active NPI

Vision Palace II, Inc

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1114124633
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006530-1 Issued in NY
Legal business name
VISION PALACE II, INC
Practice address
2027 Emmons Ave
Brooklyn, NY 11235-2781
Phone
(718) 648-2020
Fax
(718) 648-2006
NPI assigned
Jun 28, 2007
Last updated
Apr 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Mr. Igor Valery Supitskiy, OPHTHALMIC DISPENSER
Title
President
Phone
(718) 648-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006530-1 NY Primary

Addresses

Primary practice location

2027 Emmons Ave
Brooklyn, NY 11235-2781

Mailing address

2027 Emmons Ave
Brooklyn, NY 11235-2781
Phone (718) 648-2020

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1114124633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 EMMONS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352781",
            "telephone_number": "718-648-2020",
            "fax_number": "718-648-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 EMMONS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352781",
            "telephone_number": "718-648-2020",
            "fax_number": "718-648-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION PALACE II, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "SUPITSKIY",
        "authorized_official_first_name": "IGOR",
        "authorized_official_middle_name": "VALERY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-648-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPHTHALMIC DISPENSER"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006530-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.