Organization Active NPI

Dyckman Optical Inc

  • Optometrist
  • New York, NY
National Provider Identifier
1992053987
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DYCKMAN OPTICAL INC
Practice address
110 Dyckman St
New York, NY 10040-1001
Phone
(212) 567-7084
NPI assigned
Aug 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Authorized official

Name
David Rogot, OPTICIAN
Title
President
Phone
(212) 567-7084

Specialties & licenses 1

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

Addresses

Primary practice location

110 Dyckman St
New York, NY 10040-1001

Mailing address

110 Dyckman St
New York, NY 10040-1001
Phone (212) 567-7084

Other identifiers 1

IdentifierTypeStateIssuer
03529797MedicaidNY

National Provider Directory

National Provider Directory

Locations

110 Dyckman St
Ste B
New York, NY 10040
Phone (212) 567-7084

NPI Registry JSON

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1992053987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DYCKMAN ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401001",
            "telephone_number": "212-567-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DYCKMAN ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401001",
            "telephone_number": "212-567-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYCKMAN OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-22",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "ROGOT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-567-7084",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03529797",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.