Active NPI
SVC of Elmhurst LLC
- Optometrist
- Elmhurst, NY
National Provider Identifier
1134739493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- SVC OF ELMHURST LLC
- Practice address
- 8635 Queens Blvd
Elmhurst, NY 11373-4434 - Phone
- (631) 727-2858
- NPI assigned
- Aug 3, 2020
- Last updated
- Dec 3, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey S Williams Jr., OD
- Title
- Authorized Official/Owner
- Phone
- (631) 272-2858
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | NU | ||
| Optometrist | 152W00000X | NU | Primary |
Addresses
Primary practice location
8635 Queens Blvd
Elmhurst, NY 11373-4434
Mailing address
1224 Ostrander Avenue
Riverhead, NY 11901
Phone (631) 727-2858
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Ophthalmology Physician
- Elmhurst, NY
- NPI 1093725715
-
- Optician
- Elmhurst, NY
- NPI 1902214208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1606953600000",
"number": "1134739493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 OSTRANDER AVENUE",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "11901",
"telephone_number": "631-727-2858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8635 QUEENS BLVD",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113734434",
"telephone_number": "631-727-2858"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SVC OF ELMHURST LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-01",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OWNER",
"authorized_official_telephone_number": "631-272-2858",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.