Eyesite Vision III Incorporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT006065 Issued in NY

Legal business name

EYESITE VISION III INCORPORATION

Practice address

446 Knickerbocker Ave
Brooklyn, NY 11237-4509

Phone

(718) 455-6500

Fax

(718) 455-6507

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Clement E Idehen, O.DNPI 1700075595

Title

Owner

Phone

(917) 650-0190

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clement Enorense Idehen, O.D

  • Corneal and Contact Management Optometrist
  • Ridgewood, NY
  • NPI 1700075595
  NPD (past) Authorized official

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1891722138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 KENSINGTON",
            "address_2": "LYNBROOK",
            "city": "LONG ISLAND",
            "state": "NY",
            "postal_code": "115632711",
            "telephone_number": "917-650-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374509",
            "telephone_number": "718-455-6500",
            "fax_number": "718-455-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYESITE VISION III INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "IDEHEN",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-650-0190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT006065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02705526",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyes on 14 St Inc
• Eyes on Kids LLC
• Eyes on Liberty
• Eyes on the Slope
• Eyesite Vision II
• Eyevista Optometry of 86, LLC
• Chudi Christian Eyiuche, MD
• Allande Eyma, LPN
• Rebecca Eyre, LMHC, LPC
• Katherine E Eytcheson, LMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.