Organization Active NPI

Geppetto Management Corp

  • Optometrist
  • East Setauket, NY
National Provider Identifier
1528347374
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GEPPETTO MANAGEMENT CORP
Practice address
3990 Nesconset Hwy
East Setauket, NY 11733-3334
Phone
(631) 474-3808
NPI assigned
Aug 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Authorized official

Name
Dr. Dmitry Gutkovich, OD
Title
Secretary
Phone
(718) 631-8211

Specialties & licenses 1

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

Addresses

Primary practice location

3990 Nesconset Hwy
East Setauket, NY 11733-3334

Mailing address

14 Scenicview Cres
Manorville, NY 11949-2978
Phone (631) 830-3800

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": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1528347374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SCENICVIEW CRES",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492978",
            "telephone_number": "631-830-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 NESCONSET HWY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333334",
            "telephone_number": "631-474-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEPPETTO MANAGEMENT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "GUTKOVICH",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "718-631-8211",
        "authorized_official_name_prefix": "Dr.",
        "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 East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.