Long Island Ophthalmology PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

200226 Issued in NY

Legal business name

LONG ISLAND OPHTHALMOLOGY PC

Practice address

305 Hillside Avenue
Williston Park, NY 11596-2102

Phone

(516) 747-4011

Fax

(516) 747-1277

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jack B Cook, MD

Title

MD

Phone

(516) 747-4011

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1669543229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FIELDSTONE LANE",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117713122",
            "telephone_number": "516-626-3812",
            "fax_number": "516-626-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HILLSIDE AVENUE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962102",
            "telephone_number": "516-747-4011",
            "fax_number": "516-747-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND OPHTHALMOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "516-747-4011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "200226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01832228",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Williston Park, NY
• Providers in Williston Park, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.