Active NPI
Graham Eye Care LLC
- Optometrist
- Brooklyn, NY
National Provider Identifier
1174039531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Ophthalmology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI 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.