Organization Active NPI

Graham Eye Care LLC

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1174039531
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GRAHAM EYE CARE LLC
Practice address
102 Graham Ave
Brooklyn, NY 11206-3334
Phone
(718) 406-0478
Fax
(718) 705-4221
NPI assigned
Dec 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
David H Lee, MD
Title
Ophthalmologist
Phone
(718) 406-0478

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X NY

Addresses

Primary practice location

102 Graham Ave
Brooklyn, NY 11206-3334

Mailing address

102 Graham Ave
Brooklyn, NY 11206-3334
Phone (718) 406-0478

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1174039531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063334",
            "telephone_number": "718-406-0478",
            "fax_number": "718-705-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063334",
            "telephone_number": "718-406-0478",
            "fax_number": "718-705-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "718-406-0478",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.