Chic Boutique LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CHIC BOUTIQUE LLC

Practice address

168 Bedford St
Stamford, CT 06901-1901

Phone

(203) 588-0100

Fax

(203) 588-9033

NPI assigned

Nov 19, 2018

Organization subpart

No

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

Authorized official

Name

Luiza Youssefi, OD

Title

Owner

Phone

(203) 588-0100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1295204261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PITKIN HOLW",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066115612",
            "telephone_number": "212-470-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 BEDFORD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069011901",
            "telephone_number": "203-588-0100",
            "fax_number": "203-588-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIC BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "YOUSSEFI",
        "authorized_official_first_name": "LUIZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-588-0100",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.