Organization Active NPI

SVC of Elmhurst LLC

  • Optometrist
  • Elmhurst, NY
National Provider Identifier
1134739493
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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)CodeLicenseStatePrimary
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 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": "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.

Verify at the official NPI Registry.