Classic Optical Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CLASSIC OPTICAL INC.

Practice address

6516 Rising Sun Ave
Philadelphia, PA 19111-5245

Phone

(215) 722-2242

Fax

(215) 722-6544

NPI assigned

Jan 29, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Ayodale Castillo Tan

Title

Vice President

Phone

(215) 722-2242

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382400000000",
    "number": "1982942710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6516 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115245",
            "telephone_number": "215-722-2242",
            "fax_number": "215-722-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6516 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115245",
            "telephone_number": "215-722-2242",
            "fax_number": "215-722-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-10-22",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "AYODALE",
        "authorized_official_middle_name": "CASTILLO",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-722-2242",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nilda Claudio, BSW
• Lindsey Anne Claus
• Jonathan Peter Clausen, MD
• Auston Clauss, PA-C

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

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