Rainer N Mittl Ophthalmologist PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

113621 Issued in NY

Legal business name

RAINER N MITTL OPHTHALMOLOGIST PC

Practice address

1655 Hammersley Ave FL 2
Bronx, NY 10469-3113

Phone

(212) 305-5030

NPI assigned

Mar 4, 2008

Reactivated

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rainer N Mittl, MD

Title

Ophthalmologist

Phone

(212) 305-5030

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1154591311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 HAMMERSLEY AVE FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693113",
            "telephone_number": "212-305-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 HAMMERSLEY AVE FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693113",
            "telephone_number": "212-305-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINER N MITTL OPHTHALMOLOGIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "deactivation_date": "2008-03-11",
        "reactivation_date": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "MITTL",
        "authorized_official_first_name": "RAINER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "212-305-5030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "113621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00206964",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.