Sioc@Bay St Optical Pavilion

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV004813-1 Issued in NY

Legal business name

SIOC@BAY ST OPTICAL PAVILION

Practice address

664 Bay St
Optical
Staten Island, NY 10304-3829

Phone

(718) 727-5678

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carolyn Rosemary Powell Rivers, OD

Title

Principle

Phone

(718) 727-5678

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bay Street Optical Pavilion Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryant Edward Pearson, OPHTHALMIC DISPENSER

  • Optician
  • Staten Island, NY
  • NPI 1548746811
  NPD (past)

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1154594190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 BAY ST",
            "address_2": "OPTICAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 BAY ST",
            "address_2": "OPTICAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043829",
            "telephone_number": "718-727-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOC@BAY ST OPTICAL PAVILION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "POWELL RIVERS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "ROSEMARY",
        "authorized_official_title_or_position": "PRINCIPLE",
        "authorized_official_telephone_number": "718-727-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004813-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01065163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Street Optical Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abhinav Nath Sinha, D.M.D.
• Aditi Sinha, MD
• Ashish Sinha, DPT
• Rabindra P Sinha, MD
• Elvira Sinodskaya
• Sipa, PLLC
• Jennifer Ann Siracusa, MS., ED.
• Lisa Siracusa, RPA
• Mariano Siragusa
• Mary Siragusa, RN

• Optometrist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.