Organization Active NPI

VZ Optical

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1790859874
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003411-1 Issued in NY
Legal business name
VZ OPTICAL
Practice address
2655 Richmond Ave
Staten Island, NY 10314-5821
Phone
(718) 698-6666
Fax
(718) 698-0223
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Authorized official

Name
Michelle Ericksen
Title
Assistant
Phone
(718) 698-6666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV003411-1 NY Primary

Addresses

Primary practice location

2655 Richmond Ave
Staten Island, NY 10314-5821

Mailing address

2655 Richmond Ave
Staten Island, NY 10314-5821
Phone (718) 698-6666

Other identifiers 1

IdentifierTypeStateIssuer
02283067MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Eye to Eye Vision Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2655 Richmond Ave
Staten Island, NY 10314
Phone (718) 698-6666

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1790859874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145821",
            "telephone_number": "718-698-6666",
            "fax_number": "718-698-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145821",
            "telephone_number": "718-698-6666",
            "fax_number": "718-698-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VZ OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "ERICKSEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "718-698-6666"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003411-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02283067",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.