NPIMap

Organization Active NPI

Kelly Optometry, a Professional Corporation

  • Optometrist
  • New Hyde Park, NY
National Provider Identifier
1972206688
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KELLY OPTOMETRY, A PROFESSIONAL CORPORATION
Practice address
1979 Marcus Ave Ste 206
New Hyde Park, NY 11042-1002
Phone
(877) 506-0002
Fax
(516) 243-8724
NPI assigned
Mar 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Susan Christopher-Brand
Title
Manager
Phone
(380) 223-3412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1979 Marcus Ave Ste 206
New Hyde Park, NY 11042-1002

Mailing address

1979 Marcus Ave Ste 206
New Hyde Park, NY 11042-1002
Phone (877) 506-0002

National Provider Directory

National Provider Directory
Tax ID family
Kelly Optometry a Professional Corporation11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1972206688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1979 MARCUS AVE STE 206",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421002",
            "telephone_number": "877-506-0002",
            "fax_number": "516-243-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 MARCUS AVE STE 206",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421002",
            "telephone_number": "877-506-0002",
            "fax_number": "516-243-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY OPTOMETRY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "CHRISTOPHER-BRAND",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "380-223-3412"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.