Individual provider Active NPI

David Muladzhanov

  • Optician
  • Great Neck, NY
National Provider Identifier
1629958731
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
01060301 Issued in NY
Practice address
29A Middle Neck Rd
Great Neck, NY 11021-2319
Phone
(718) 440-5682
NPI assigned
Sep 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 01060301 NY Primary

Addresses

Primary practice location

29A Middle Neck Rd
Great Neck, NY 11021-2319

Mailing address

29A Middle Neck Rd
Great Neck, NY 11021-2319
Phone (718) 440-5682

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

LicenseStateTypeSpecialty
01060301NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Eyecare Optician CurrentSince Sep 14, 2025 Accepting new patients

Locations

29A Middle Neck Rd
Great Neck, NY 11021
Phone (718) 440-5682

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1629958731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29A MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212319",
            "telephone_number": "718-440-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29A MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212319",
            "telephone_number": "718-440-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULADZHANOV",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "01060301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.