Medelite Group PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MEDELITE GROUP PC

Practice address

1 Sienna Way
Lakewood, NJ 08701-2121

Phone

(718) 534-0689

NPI assigned

Dec 10, 2014

Organization subpart

No

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

Authorized official

Name

Abigail Meade, OD

Title

Owner

Phone

(216) 374-0194

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1881092617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SIENNA WAY",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SIENNA WAY",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012121",
            "telephone_number": "718-534-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDELITE GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "MEADE",
        "authorized_official_first_name": "ABIGAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-374-0194",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.