NPIMap

Organization Active NPI

Ridgewood Optical Warehouse Outlet Corp.

  • Eyewear Supplier
  • Ridgewood, NY
National Provider Identifier
1467501650
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
07646 Issued in NY
Legal business name
RIDGEWOOD OPTICAL WAREHOUSE OUTLET CORP.
Practice address
6041 Myrtle Ave
Ridgewood, NY 11385-5933
Phone
(718) 386-2423
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edward Davidov
Title
Optician,Manager
Phone
(718) 386-2423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 07646 NY Primary

Addresses

Primary practice location

6041 Myrtle Ave
Ridgewood, NY 11385-5933

Mailing address

6041 Myrtle Ave
Ridgewood, NY 11385-5933
Phone (718) 386-2423

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467501650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855933",
            "telephone_number": "718-386-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855933",
            "telephone_number": "718-386-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD OPTICAL WAREHOUSE OUTLET CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIDOV",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OPTICIAN,MANAGER",
        "authorized_official_telephone_number": "718-386-2423",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "07646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.