Eyes on Broadway Sa Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EYES ON BROADWAY SA INC

Practice address

825 Broadway
New York, NY 10003

Phone

(212) 475-0999

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Stan Fuzaylov

Title

Owner

Phone

(917) 412-3750

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise M Whittam, OD

  • Optometrist
  • New York, NY
  • NPI 1699742403
  Medicare reassignment NPD

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1396527222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034702",
            "telephone_number": "212-475-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-475-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES ON BROADWAY SA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "FUZAYLOV",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-412-3750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyes & Optics Harlem LLC
• Eyes & Optics Metro LLC (GVS Metropolitan Hospital)
• Eyes for U Optical
• Eyes on Broadway
• Eyes on Broadway I, LLC
• Eyes on the World of Lexington, Inc.
• Eyes on the World of Lexington, Inc.
• Eyes Open Optical Boutique
• Eyesmate Optical Inc
• Nicholas Eynon, MD

• Eyewear Supplier in New York, NY
• Providers in New York, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.