Brenda Botwinick, OD
Individual provider Active NPI Optometrist · Northport, NY
NPI 1245803014 · NPPES record last updated Jul 20, 2021
Key facts
- NPI
- 1245803014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- TUV009359 (NY)
- Practice address
- 79 Middleville Rd
Northport, NY 11768-2200 - Phone
- (631) 261-4400
- NPI assigned
- Jul 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV009359 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Namdar Optometry PC | Optometrist | Current |
Accepting new patients |
Locations
10 Brower Ave
Woodmere, NY 11598
Phone (516) 239-4677
Interoperability endpoints
- brenda.botwinick@va.gov
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV009359 | NY | Yes |
Addresses
Primary practice location
79 Middleville Rd
Northport, NY 11768-2200
Mailing address
533 Hicksville Rd
Far Rockaway, NY 11691-5423
Phone (646) 628-3673
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Brenda.Botwinick@va.gov |
Other providers in Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.