Bruce David Mirkin
Individual provider Active NPI Optician · Rockville Centre, NY
NPI 1871661132 · NPPES record last updated Apr 8, 2008
Key facts
- NPI
- 1871661132
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 004817-1 (NY)
- Practice address
- 28 S Park Ave
Rockville Centre, NY 11570-5280 - Phone
- (516) 766-2800
- Fax
- (516) 766-0222
- NPI assigned
- Dec 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004817-1 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accent on Eyes Corp. | Current | Accepting new patients | |
| Accent on Eyes Corp. | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 004817-1 | NY | Yes |
Addresses
Primary practice location
28 S Park Ave
Rockville Centre, NY 11570-5280
Mailing address
28 S Park Ave
Rockville Centre, NY 11570-5280
Phone (516) 766-2800
Other providers in Rockville Centre, NY
- Tina Minicozzi
- Minimally Invassive Surgical Associates of Long Island
- Rene Minter-Carr
- Natalia C Mirabal Alonso
- Angelina Francis Miraglio
- Richard M. Mirra
- Mission Medical Care PC
- Charles Allen Mitgang
- Yahya Moadel
- Sassan Mohtadi
All providers in Rockville Centre, NY · Optician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.