Mazy Eye Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003001 Issued in PA

Legal business name

MAZY EYE INC.

Doing business as

Premier Family Eyecare

Practice address

4000 Monument Rd
Philadelphia, PA 19131-1600

Phone

(215) 220-4455

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Qurtullean Malik, OD

Title

Optometrist

Phone

(609) 638-0102

Specialties & licenses 1

Addresses

Other names 1

• Premier Family Eyecare Doing business as

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1376056978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CLYDESDALE CIR",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190674114",
            "telephone_number": "609-638-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MONUMENT RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311600",
            "telephone_number": "215-220-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZY EYE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "QURTULLEAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "609-638-0102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cyrus Mazidi, M.D.
• Tracy Mazique, MCC
• Dana S Mazo
• Rebecca C Mazur
• Jeremy Aryeh Mazurek, MD
• Dayna Mazza, M.D.
• Marisa Mazza, PA-C
• Lydia Mazze, MD
• Shannon Mazzei
• Allison Mazzella, MS

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.