Indigo Optical Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007499 Issued in NY

Legal business name

INDIGO OPTICAL INC.

Practice address

3241 Steinway St Ste a
Astoria, NY 11103-4036

Phone

(347) 808-9155

NPI assigned

Nov 4, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Robert Yusupov

Title

Owner/Optician

Phone

(347) 808-9155

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1851678809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 STEINWAY ST STE A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 STEINWAY ST STE A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034036",
            "telephone_number": "347-808-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "347-808-9155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ellya Indradjaja, LMHC
• Indranil Gupta, Physician, PC
• Infectious Disease Associate, PLLC
• Infinity Medical Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.