Wynn Optics II Corp

Primary specialty

OptometristTaxonomy code 152W00000X

License

007388 Issued in NY

Legal business name

WYNN OPTICS II CORP

Doing business as

wynn optics

Practice address

629 Malcolm X Blvd
New York, NY 10037-1231

Phone

(212) 491-1500

Fax

(212) 491-1509

NPI assigned

Jan 9, 2015

Organization subpart

No

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

Authorized official

Name

Bernice Sandoval

Title

Owner

Phone

(212) 491-1500

Specialties & licenses 2

Addresses

Other names 1

• wynn optics Doing business as

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1467841718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 MALCOLM X BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371231",
            "telephone_number": "212-491-1500",
            "fax_number": "212-491-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 MALCOLM X BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371231",
            "telephone_number": "212-491-1500",
            "fax_number": "212-491-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNN OPTICS II CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-491-1500"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007388",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "wynn optics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Herbert M Wyman, M.D.
• Neila Cohalan Wyman, LCSW, PA
• Eva F Wyner, MA, CCC-SLP
• Juliana Kate Wynkoop
• Wynn Optics Corp (Wynn Opitcs)
• Alyssa Wynn, LCSW
• Cymone Wynn
• Danielle Wynn
• Dejuan Lamont Wynn, OPTICIAN
• Eleanor Grace Wynn, MHC-LP

• Optometrist in New York, NY
• Providers in New York, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.