Northport Optical Center Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

TUV003407 Issued in NY

Legal business name

NORTHPORT OPTICAL CENTER INC.

Practice address

834 Fort Salonga Rd
Northport, NY 11768-3157

Phone

(631) 757-4440

Fax

(631) 757-4593

NPI assigned

Mar 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael Tanenbaum, O.D.NPI 1376510503

Title

President

Phone

(631) 757-4440

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michael Tanenbaum, O.D.

  • Optometrist
  • Northport, NY
  • NPI 1376510503
  NPD (past) Authorized official

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922075423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 FORT SALONGA RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683157",
            "telephone_number": "631-757-4440",
            "fax_number": "631-757-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 FORT SALONGA RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683157",
            "telephone_number": "631-757-4440",
            "fax_number": "631-757-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT OPTICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANENBAUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-757-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "TUV003407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Joseph Nissen, PH.D.
• North Shore Medical Care, P.C.
• North Shore Wellness
• Northport Chemists Inc
• Northport Family Medicine P.C
• Northport Physical Therapy P C
• Northport Podiatry PC
• Northport VA
• Northport VA Medical Center
• Northport Vamc

• Eyewear Supplier in Northport, NY
• Providers in Northport, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.