DLJ Spectacles

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DLJ SPECTACLES

Doing business as

Southside Family Vision

Practice address

2 W Main St
Bay Shore, NY 11706-8309

Phone

(631) 813-1112

NPI assigned

Nov 2, 2018

Last updated

Nov 2, 2018By 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

Stuart Dawson

Title

Owner

Phone

(631) 813-1112

Specialties & licenses 1

Addresses

Other names 1

• Southside Family Vision Doing business as

Locations

Practitioners 2

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.

• Lisa Cellura

  • Optician
  • Bay Shore, NY
  • NPI 1992044218
  NPD (past)
• Marissa Cristina Povol, O.D.

  • Optometrist
  • Bay Shore, NY
  • NPI 1922537463
  NPD (past)

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541116800000",
    "number": "1629545157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068309",
            "telephone_number": "631-813-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068309",
            "telephone_number": "631-813-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLJ SPECTACLES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-02",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-813-1112"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Dilena
• Florence Ann Dimartino, NP
• Adeshola Dirisu, LPN
• Discover Podiatry, P.C.
• Christina Marie Divittorio, RN
• Jaclynn DO, MD
• Jannika Dodge Khatami, M.D.
• Jonathan Doering
• Mary Doherty, MS ED/SPEC ED CERT
• Ryan Alexander Doherty

• Optometrist in Bay Shore, NY
• Providers in Bay Shore, 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 2, 2018; 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.