Organization Active NPI

Coopercrwn Ny Corp

  • Optometrist
  • Bayside, NY
National Provider Identifier
1760939730
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COOPERCRWN NY CORP
Practice address
20939 Northern Blvd
Bayside, NY 11361-3134
Phone
(347) 502-7850
NPI assigned
Sep 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Authorized official

Name
Sean Kim
Title
President
Phone
(201) 731-3587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

20939 Northern Blvd
Bayside, NY 11361-3134

Mailing address

20939 Northern Blvd
Bayside, NY 11361-3134
Phone (201) 731-3587

Other names 1

  • coopercrwn Other name

National Provider Directory

National Provider Directory

Locations

95 Cedar Ln
#A
Englewood, NJ 07631

20939 Northern Blvd
Bayside, NY 11361
Phone (347) 502-7850

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": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1760939730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20939 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613134",
            "telephone_number": "201-731-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20939 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613134",
            "telephone_number": "347-502-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERCRWN NY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-731-3587"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "coopercrwn",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "coopercrwn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.