Organization Active NPI

Woodside Optical Corp.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1346583655
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005920 Issued in NY
Legal business name
WOODSIDE OPTICAL CORP.
Doing business as
new view vision
Practice address
202 7TH Ave
Brooklyn, NY 11215-6733
Phone
(845) 673-3613
Fax
(718) 505-1414
NPI assigned
Apr 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Roman Kulberg, OWNER
Title
Owner
Phone
(845) 673-3613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV005920 NY Primary

Addresses

Primary practice location

202 7TH Ave
Brooklyn, NY 11215-6733

Mailing address

6108 Woodside Ave
Woodside, NY 11377-3543
Phone (718) 505-1700

Other names 1

  • new view vision Doing business as

National Provider Directory

National Provider Directory

Locations

6108 Woodside Ave
Woodside, NY 11377
Phone (718) 505-1700

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1346583655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6108 WOODSIDE AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773543",
            "telephone_number": "718-505-1700",
            "fax_number": "718-505-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156733",
            "telephone_number": "845-673-3613",
            "fax_number": "718-505-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSIDE OPTICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "KULBERG",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-673-3613",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "new view vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.