Atlantic Optical, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006692 Issued in NY

Legal business name

ATLANTIC OPTICAL, INC

Practice address

139 Flatbush Ave
#15
Brooklyn, NY 11217-1450

Phone

(718) 522-3737

Fax

(718) 522-3894

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Alla Dyatlov, OPTICIANNPI 1205018488

Title

Owner

Phone

(718) 522-3737

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bindu Thomas, O.D.

  • Optometrist
  • New York, NY
  • NPI 1912043092
  Medicare reassignment NPD
• Alla Dyatlov, OPTICIAN

  • Optician
  • Brooklyn, NY
  • NPI 1205018488
  NPD Authorized official

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1609055581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FLATBUSH AVE",
            "address_2": "#15",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171450",
            "telephone_number": "718-522-3737",
            "fax_number": "718-522-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FLATBUSH AVE",
            "address_2": "#15",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171450",
            "telephone_number": "718-522-3737",
            "fax_number": "718-522-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC OPTICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "DYATLOV",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-522-3737",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02950223",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Atlantic Gastroenterology, P.C.
• Atlantic Heights Pharmacy Inc
• Atlantic Heights Specialty Script Corp (Atlantic Heights Pharmacy)
• Atlantic Medical PC
• Atlantic Medical Plaza PC
• Atlantic Pharma Corp. (Downtown Rx Pharmacy)
• Atlantic Pharmacy Group Inc
• Atlantic Podiatry PLLC
• Atlantic Radiology Imaging PC
• Atlantic Radiology, PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.