1038 SB Optical Corp

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

1038 SB OPTICAL CORP

Doing business as

Metro Optics Eyewear III

Practice address

1038 Southern Blvd
Bronx, NY 10459-3407

Phone

(718) 328-7137

NPI assigned

Sep 22, 2009

Last updated

Apr 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eva Yan, O.D.

Title

President/Optometrist

Phone

(718) 328-7137

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Metro Optics Eyewear III Doing business as

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1942534078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593407",
            "telephone_number": "718-328-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593407",
            "telephone_number": "718-328-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1038 SB OPTICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "718-328-7137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03168967",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Optics Eyewear III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Bronx, NY
• Providers in Bronx, 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 16, 2013; 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.