Active NPI
Mark Edwin Boyle, LICENSED OPHTHALMIC
- Optician
- Queensbury, NY
National Provider Identifier
1619483948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 008504-1
- Practice address
- 24 Quaker RDG
Queensbury, NY 12804-1556 - Phone
- (518) 746-4159
- NPI assigned
- Dec 22, 2017
- Last updated
- Dec 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 008504-1 | NY | Primary |
Addresses
Primary practice location
24 Quaker RDG
Queensbury, NY 12804-1556
Mailing address
24 Quaker RDG
Queensbury, NY 12804-1556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008504-1 | NY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1619483948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 QUAKER RDG",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 QUAKER RDG",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041556",
"telephone_number": "518-746-4159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "MARK",
"middle_name": "EDWIN",
"credential": "LICENSED OPHTHALMIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-22",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "008504-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queensbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.