NPIMap

Organization Active NPI

The Lens Boutique

  • Optician
  • Clinton TWP, MI
National Provider Identifier
1700396231
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
THE LENS BOUTIQUE
Practice address
42524 Hayes Rd Ste 300
Clinton TWP, MI 48038-3643
Phone
(586) 228-9740
NPI assigned
Oct 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Brian Kenneth PitkoNPI 1063922722
Title
Owner
Phone
(586) 228-9740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

42524 Hayes Rd Ste 300
Clinton TWP, MI 48038-3643

Mailing address

42524 Hayes Rd Ste 300
Clinton TWP, MI 48038-3643

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1700396231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42524 HAYES RD STE 300",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42524 HAYES RD STE 300",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383643",
            "telephone_number": "586-228-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LENS BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "PITKO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-228-9740"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.