Hillside Optical Corp.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007405 Issued in NY

Legal business name

HILLSIDE OPTICAL CORP.

Doing business as

Fabulous Optical

Practice address

8902 165TH St
Jamaica, NY 11432-5126

Phone

(718) 658-0900

NPI assigned

Nov 30, 2009

Last updated

Nov 30, 2009By 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

Mr. Mark Bangiyev

Title

Owner

Phone

(718) 658-0900

Specialties & licenses 1

Addresses

Other names 1

• Fabulous Optical Doing business as

Locations

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1508194689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8902 165TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325126",
            "telephone_number": "718-658-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8902 165TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325126",
            "telephone_number": "718-658-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE OPTICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "BANGIYEV",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-658-0900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fabulous Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hillside Manor Rehabilitation and Extended Care Center, LLC
• Hillside Medical & Pain Management, PC
• Hillside Medical Care Nyc PC
• Hillside Medical Care PLLC
• Hillside Ophthalmology PC
• Hillside Polymedic Diagnostic & Treatment Center Inc
• Hillside Polymedic P.C.
• Hillside Primary Care PLLC (Alpina Healthcare)
• Hillside Radiology
• Hillside RX Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.