Active NPI
Marie Prasad Sison, O.D.
- Optometrist
- Melville, NY
National Provider Identifier
1841494036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 005566
- Practice address
- 625 Broadhollow Rd
Melville, NY 11747-5006 - Phone
- (631) 845-5039
- NPI assigned
- Jun 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 005566 | NY | Primary |
Addresses
Primary practice location
625 Broadhollow Rd
Melville, NY 11747-5006
Mailing address
63 Winnecomac Cir
Kings Park, NY 11754-4608
Phone (516) 242-7428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005566 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841494036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 WINNECOMAC CIR",
"city": "KINGS PARK",
"state": "NY",
"postal_code": "117544608",
"telephone_number": "516-242-7428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 BROADHOLLOW RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117475006",
"telephone_number": "631-845-5039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISON",
"first_name": "MARIE",
"middle_name": "PRASAD",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "005566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.