Individual provider Active NPI

Fred Slutsky, OPTICIAN

  • Optician
  • Suffern, NY
National Provider Identifier
1417115338
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
4592 Issued in NY
Practice address
214 Route 59
Suffern, NY 10901-5205
Phone
(845) 357-4787
NPI assigned
May 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 4592 NY Primary

Addresses

Primary practice location

214 Route 59
Suffern, NY 10901-5205

Mailing address

214 Route 59
Suffern, NY 10901-5205
Phone (845) 357-4787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4592NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1417115338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015205",
            "telephone_number": "845-357-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015205",
            "telephone_number": "845-357-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLUTSKY",
        "first_name": "FRED",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "4592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.