NPIMap

Organization Active NPI

Fabulous Optical USA Corp.

  • Optometrist
  • Jamaica, NY
National Provider Identifier
1427680628
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FABULOUS OPTICAL USA CORP.
Practice address
14620 Jamaica Ave
Jamaica, NY 11435-3628
Phone
(718) 355-8636
NPI assigned
Feb 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Marina Presman, ODNPI 1699243600
Title
Owner
Phone
(347) 249-3605

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

14620 Jamaica Ave
Jamaica, NY 11435-3628

Mailing address

14620 Jamaica Ave
Jamaica, NY 11435-3628
Phone (718) 355-8636

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1427680628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14620 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353628",
            "telephone_number": "718-355-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14620 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353628",
            "telephone_number": "718-355-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABULOUS OPTICAL USA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "PRESMAN",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-249-3605",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.