Eye Galleria,Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

EYE GALLERIA,INC.

Practice address

19414 Northern Blvd
Flushing, NY 11358-3033

Phone

(718) 428-0001

Fax

(718) 428-3799

NPI assigned

Jun 28, 2021

Last updated

Jun 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jaemo Park, OPHTHALMIC DISPENSER

Title

President

Phone

(718) 683-0832

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1871163378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19414 NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583033",
            "telephone_number": "718-428-0001",
            "fax_number": "718-428-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19414 NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583033",
            "telephone_number": "718-428-0001",
            "fax_number": "718-428-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE GALLERIA,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAEMO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-683-0832",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPHTHALMIC DISPENSER"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Flushing, NY
• Providers in Flushing, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.