PLC Optical Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PLC OPTICAL CORP

Practice address

460 County Road 111 Unit 8
Manorville, NY 11949-3375

Phone

(917) 602-4139

NPI assigned

Nov 2, 2018

Organization subpart

No

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

Authorized official

Name

Peter LacorteNPI 1164569133

Title

Owner

Phone

(917) 602-4139

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Manorville Eyecare Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Peter Lacorte, O.D.

  • Optometrist
  • Manorville, NY
  • NPI 1164569133
  Medicare reassignment Authorized official

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": "1659849115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 GOTHIC CIR",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492622",
            "telephone_number": "917-602-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 COUNTY ROAD 111 UNIT 8",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493375",
            "telephone_number": "917-602-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLC OPTICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-02",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "LACORTE",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-602-4139"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11502510",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manorville Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Marie Perrino, R.N.
• Jessica Petchonka, PA-C
• Debra Peters, CASAC-T, CARC
• Kerri Ann Petitpain
• Karen Diers Piddoubny, LBA
• Krystal A Porfidia
• Pure Dental of Long Island PC
• Nancy April Quintilian
• R Lee PT
• Christine E Racca, MS ED, S.D.A.

• Primary Care Clinic/Center in Manorville, NY
• Providers in Manorville, NY by specialty
• Primary Care Clinic/Center 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.
• 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.