Staten Eye Land 2 Inc

Primary specialty

OpticianTaxonomy code 156FX1800X

License

004036-1 Issued in NY

Legal business name

STATEN EYE LAND 2 INC

Practice address

1803 Victory Blvd
Staten Island, NY 10314-3515

Phone

(718) 448-7676

Fax

(718) 448-7675

NPI assigned

Mar 28, 2007

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

Mr. Alan Fruchtman, OPTICIANNPI 1063549541

Title

Owner

Phone

(714) 448-7676

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.

• Alan Fruchtman, OPTICIAN

  • Optician
  • Staten Island, NY
  • NPI 1063549541
  Authorized official Same address or phone

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619096815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143515",
            "telephone_number": "718-448-7676",
            "fax_number": "718-448-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143515",
            "telephone_number": "718-448-7676",
            "fax_number": "718-448-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN EYE LAND 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRUCHTMAN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-448-7676",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "004036-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of New York
• State of New York
• State of New York
• State of New York Comptrollers Office (Staten Island Developmental Disabilities Service Office Clinic)
• State of New York Comptrollers Office
• Staten Eye Land Inc
• Staten Isand University Hospital Van Trans Day Treatment
• Staten Island Aid for Retarded Children, Inc (Community Resources)
• Staten Island Allergy Office PC
• Staten Island Audiological Services, P.C.

• Optician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Optician in New York

• 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.