Active NPI
Valery Naymagon, OPHTHALMIC DISPENSER
- Optician
- Elizabeth, NJ
National Provider Identifier
1124133145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 31TD00337700
- Practice address
- 240 Williamson St
Suite 505
Elizabeth, NJ 07202-3674 - Phone
- (908) 289-0250
- Fax
- (908) 289-3713
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 31TD00337700 | NJ | Primary |
Addresses
Primary practice location
240 Williamson St
Suite 505
Elizabeth, NJ 07202-3674
Mailing address
3108 Nostrand Ave
Brooklyn, NY 11229-2601
Phone (718) 594-2793
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31TD00337700 | Other | NJ | OPHTHALMIC DISPENSER # |
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 |
|---|---|---|---|
| 31TD00337700 | NJ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124133145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3108 NOSTRAND AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112292601",
"telephone_number": "718-594-2793",
"fax_number": "908-289-3713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 WILLIAMSON ST",
"address_2": "SUITE 505",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072023674",
"telephone_number": "908-289-0250",
"fax_number": "908-289-3713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAYMAGON",
"first_name": "VALERY",
"name_prefix": "Mr.",
"credential": "OPHTHALMIC DISPENSER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NJ",
"license": "31TD00337700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPHTHALMIC DISPENSER #",
"identifier": "31TD00337700",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
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.