Clement Idehen Optometrist PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

T006065 Issued in NY

Legal business name

CLEMENT IDEHEN OPTOMETRIST PC

Practice address

5546 Myrtle Ave
Ridgewood, NY 11385-3554

Phone

(718) 628-9200

Fax

(718) 628-5600

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Clement Enorense Idehen, O.DNPI 1700075595

Title

President

Phone

(718) 628-9200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• eyesite vision center Doing business as

Practitioners 1

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

• Clement Enorense Idehen, O.D

  • Corneal and Contact Management Optometrist
  • Ridgewood, NY
  • NPI 1700075595
  NPD (past) Authorized official

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1760435374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5546 MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853554",
            "telephone_number": "718-628-9200",
            "fax_number": "718-628-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5546 MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853554",
            "telephone_number": "718-628-9200",
            "fax_number": "718-628-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMENT IDEHEN OPTOMETRIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "IDEHEN",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "ENORENSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-628-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T006065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02263261",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eyesite vision center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Art Anthony Cina, PHARM.D.
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• City Dental Care,PLLC
• City Medical of Upper East Side, PLLC
• City View Adult Day Center
• Alexander Cloarec, PH.D.
• Helen Coggin
• Gary Cohen
• Ilan Cohen, MD
• Elena Cojocaru, NP

• Optometrist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.