The Optical Source

Primary specialty

OptometristTaxonomy code 152W00000X

License

0004616 Issued in NY

Legal business name

THE OPTICAL SOURCE

Doing business as

Sterling Optical # 318

Practice address

1744 Veterans Memorial Highway
Islandia, NY 11749

Phone

(631) 348-4545

Fax

(631) 348-7299

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ernie Alan Rosen, DO

Title

Vice President

Phone

(631) 348-4545

Specialties & licenses 1

Addresses

Other names 1

• Sterling Optical # 318 Doing business as

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174731129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 VETERANS MEMORIAL HIGHWAY",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "11749",
            "telephone_number": "631-348-4545",
            "fax_number": "631-348-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 VETERANS MEMORIAL HIGHWAY",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "11749",
            "telephone_number": "631-348-4545",
            "fax_number": "631-348-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPTICAL SOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "ERNIE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "631-348-4545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "0004616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sterling Optical # 318",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Islandia, NY
• Providers in Islandia, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.