Organization Active NPI

Optimum Optometry & Ophthalmic Dispensing Eyecare PLLC

  • Eyewear Supplier
  • Astoria, NY
National Provider Identifier
1902184641
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
55008562 Issued in NY
Legal business name
OPTIMUM OPTOMETRY & OPHTHALMIC DISPENSING EYECARE PLLC
Practice address
3117 23Rd Ave
Astoria, NY 11105-2488
Phone
(718) 626-9400
Fax
(718) 626-9499
NPI assigned
Jul 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Authorized official

Name
Mr. Alexandr Kozochonok
Title
Coowner
Phone
(917) 420-3824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 55008562 NY Primary

Addresses

Primary practice location

3117 23Rd Ave
Astoria, NY 11105-2488

Mailing address

3117 23Rd Ave
Astoria, NY 11105-2488
Phone (718) 626-9400

Other names 1

  • OPTIMUM EYE CARE Doing business as

National Provider Directory

National Provider Directory

Locations

3117 23rd Ave
Astoria, NY 11105
Phone (718) 626-9400

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1902184641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 23RD AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052488",
            "telephone_number": "718-626-9400",
            "fax_number": "718-626-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 23RD AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052488",
            "telephone_number": "718-626-9400",
            "fax_number": "718-626-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM OPTOMETRY & OPHTHALMIC DISPENSING EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "KOZOCHONOK",
        "authorized_official_first_name": "ALEXANDR",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "19174203824",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "55008562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTIMUM EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.