Active NPI
Yuliya Shimunov, OPHTHALMIC DISPENSER
- Optician
- Ridgewood, NY
National Provider Identifier
1679120927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 007920-1
- Practice address
- 6240 Forest Ave
Ridgewood, NY 11385-1929 - Phone
- (718) 418-0100
- Fax
- (718) 418-0005
- NPI assigned
- Aug 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 007920-1 | NY | Primary |
Addresses
Primary practice location
6240 Forest Ave
Ridgewood, NY 11385-1929
Mailing address
6240 Forest Ave
Ridgewood, NY 11385-1929
Phone (718) 418-0100
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 |
|---|---|---|---|
| 007920-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566345600000",
"number": "1679120927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6240 FOREST AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851929",
"telephone_number": "718-418-0100",
"fax_number": "718-418-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6240 FOREST AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851929",
"telephone_number": "718-418-0100",
"fax_number": "718-418-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMUNOV",
"first_name": "YULIYA",
"name_prefix": "Ms.",
"credential": "OPHTHALMIC DISPENSER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-21",
"last_updated": "2019-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "007920-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.