NPI Code Detail JSON Logo

1194226886 NPI number — ESAD OPTICAL, INC

NPI Number: 1194226886
Health Care Provider/Practitioner: ESAD OPTICAL, INC

Information about “1194226886” NPI (ESAD OPTICAL, INC) exists in 1194226886 in HTML format HTML  |  1194226886 in plain Text format TXT  |  1194226886 in PDF (Portable Document Format) PDF  |  1194226886 in an XML format XML  formats.

NPI Number : 1194226886 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194226886",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ESAD OPTICAL, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "708 SEABURY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRANKLIN SQUARE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11010-4112",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "516-641-1768",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6332 NORTHERN BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EAST NORWICH",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11732-1600",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "516-624-3149",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/27/2018",
    "LastUpdateDate": "06/16/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DE JUNCO",
    "AuthorizedOfficialFirstName": "ELISA",
    "AuthorizedOfficialMiddleName": "F",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "OD",
    "AuthorizedOfficialTelephoneNumber": "516-641-1768",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152WC0802X",
          "TaxonomyName": "Corneal and Contact Management Optometrist",
          "LicenseNumber": "TUV004987",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "152WS0006X",
          "TaxonomyName": "Sports Vision Optometrist",
          "LicenseNumber": "TUV004987",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": "TUV004987",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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