The Optical Room Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

003478 Issued in NY

Legal business name

THE OPTICAL ROOM INC

Practice address

20 West Ave
Brockport, NY 14420-1304

Phone

(585) 637-5858

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Douglas Cervello

Title

Owner Optician

Phone

(585) 637-5858

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• the towpath optician Doing business as

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1295810182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WEST AVE",
            "address_2": "P.O. BOX 374",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201304",
            "telephone_number": "585-637-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201304",
            "telephone_number": "585-637-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPTICAL ROOM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "CERVELLO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER  OPTICIAN",
        "authorized_official_telephone_number": "585-637-5858",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NY",
            "license": "003478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01712234",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD VISION",
            "identifier": "8779",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "the towpath optician",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary E Tatar, PT
• Trista Jamie Teets
• Tender Loving Family Care, Inc.
• Yen-Tung Andy Teng, DDS
• Thomas Maxwell Thaney, D.D.S.
• Madison Theetge, RN, BSN
• Thomas Maxwell Thaney D.D.S.
• Joseph Timpani, RPH
• David Martin Tinkelman, MD
• Adam Tinkous, RPH

• Customized Equipment (DME) in Brockport, NY
• Providers in Brockport, NY by specialty
• Customized Equipment (DME) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.