Igor Valery Supitskiy, OPHTHALMIC DISPENSER

Primary specialty

OpticianTaxonomy code 156FX1800X

License

007691-1 Issued in NY

Practice address

1018 Nostrand Ave # C
Brooklyn, NY 11225-3509

Phone

(718) 773-9391

Fax

(718) 773-9391

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• E&I Optical, Inc

  dba Vision Palace

  • Optometrist
  • Brooklyn, NY
  • NPI 1164518577

  Optician

  NPD Authorized official
• Primary Glasses

  • Optometrist
  • Brooklyn, NY
  • NPI 1649781949
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255427654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352607",
            "telephone_number": "718-773-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 NOSTRAND AVE # C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253509",
            "telephone_number": "718-773-9391",
            "fax_number": "718-773-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPITSKIY",
        "first_name": "IGOR",
        "middle_name": "VALERY",
        "name_prefix": "Mr.",
        "credential": "OPHTHALMIC DISPENSER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "007691-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02241078",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Superior Sleep Services Inc.
• Superior Support Ny Inc.
• Superior Support Store Corporation
• Superior Tech Supplies Inc.
• Superlative Smiles Dental P.C.
• Stacey Leigh Suplizio, OTR/L
• Yanina Suponitskaya, PHARM.D., BCPS
• Ianina Suponitsky, AGNP
• Anna Suponya, M.D.
• Support Transportation Inc.

• Optician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.