Bangor Mall Eye Association

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT805 Issued in ME

Legal business name

BANGOR MALL EYE ASSOCIATION

Practice address

663 Stillwater Ave
Bangor, ME 04401-3642

Phone

(207) 262-7192

NPI assigned

Aug 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Joseph Giardina, D.O.NPI 1750324638

Title

Optometrist

Phone

(207) 262-7192

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Joseph Giardina Jr., OD

  • Optometrist
  • Bradenton, FL
  • NPI 1750324638
  NPD (past) Authorized official

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487667168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013642",
            "telephone_number": "207-262-7192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013642",
            "telephone_number": "207-262-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANGOR MALL EYE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIARDINA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "207-262-7192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bangor Eye Surgery, PA
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• Bangor Plastic and Hand Surgery, P.a.
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• Bangor Surgical Associates, P.a.
• Emily Banks, DPT

• Optometrist in Bangor, ME
• Providers in Bangor, ME by specialty
• Optometrist in Maine

• 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.