Nicky Despotidis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

270A00469400 Issued in NJ

Practice address

1777 Kuser Rd
Hamilton Square, NJ 08690-3703

Phone

(609) 581-5755

Fax

(609) 581-7055

NPI assigned

Jun 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicholas Despotidis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1801091129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LEONARD DR",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511664",
            "telephone_number": "732-972-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 KUSER RD",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086903703",
            "telephone_number": "609-581-5755",
            "fax_number": "609-581-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPOTIDIS",
        "first_name": "NICKY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00469400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLAS",
            "last_name": "DESPOTIDIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel S. Kessel MD PC
• Joseph Deblasio, M.D.
• Joseph Deblasio Jr., M.D.
• Alicia Michelle Defonte, OD
• Michael Deluca, DMD
• Edward B Didonato, OD
• Cung T Dinh, M.D.
• Irving Djeng, DMD
• Margaret Mary Estlow, PNP-BC
• Eyecare Professionals, P.C.

• Optometrist in Hamilton Square, NJ
• Providers in Hamilton Square, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.