NPIMap

Organization Active NPI

Optical Warehouse Outlet of Brooklyn Inc

  • Exclusive Provider Organization
  • Brooklyn, NY
National Provider Identifier
1982646477
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
OPTICAL WAREHOUSE OUTLET OF BROOKLYN INC
Practice address
844 Flatbush Ave
Brooklyn, NY 11226-3189
Phone
(718) 941-8585
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Authorized official

Name
Yury DavydovNPI 1275577041
Title
President
Phone
(718) 941-8585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

844 Flatbush Ave
Brooklyn, NY 11226-3189

Mailing address

844 Flatbush Ave
Brooklyn, NY 11226-3189

Other identifiers 2

IdentifierTypeStateIssuer
02385817MedicaidNY
01986263MedicaidNY

National Provider Directory

National Provider Directory

Locations

844 Flatbush Ave
Ste 2
Brooklyn, NY 11226

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1982646477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263189",
            "telephone_number": "718-941-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL WAREHOUSE OUTLET OF BROOKLYN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "YURY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-941-8585"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02385817",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01986263",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.