NPIMap

Organization Active NPI

Bazan Optometric Services LLC

  • Optometrist
  • Bronx, NY
National Provider Identifier
1134517584
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
006867 Issued in NY
Legal business name
BAZAN OPTOMETRIC SERVICES LLC
Practice address
815 Hutchinson River Pkwy
Inside Target Optical
Bronx, NY 10465-1887
Phone
(718) 822-2305
NPI assigned
Jan 7, 2015
Last updated
Aug 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Dr. Justin Bazan, O.D.
Title
Owner
Phone
(646) 496-7365

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 006867 NY Primary

Addresses

Primary practice location

815 Hutchinson River Pkwy
Inside Target Optical
Bronx, NY 10465-1887

Mailing address

682 Union St
Park Slope Eye
Brooklyn, NY 11215-2047

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1134517584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 UNION ST",
            "address_2": "PARK SLOPE EYE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HUTCHINSON RIVER PKWY",
            "address_2": "INSIDE TARGET OPTICAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651887",
            "telephone_number": "718-822-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAZAN OPTOMETRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "BAZAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-496-7365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.