OPTICAL SHOP OF DEER PARK INC (NPI# 1386101632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386101632 |
| Entity Type | Organization |
| Organization Name | OPTICAL SHOP OF DEER PARK INC |
| Practice Address |
415 Commack Rd Ste 2b Deer Park NY 11729-4508 |
| Practice Telephone | 6313920711 |
| Practice Fax Number | 6313920752 |
| Mailing Telephone | 6313920711 |
| Mailing Fax Number | 6313920752 |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | LEONID GLADSTEIN (OWNER) |
| Authorized Official Telephone | 9178878872 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Street Address |
415 COMMACK RD STE 2B |
| City | DEER PARK |
| State | NY |
| Zip Code | 11729-4508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013561513 | Elyse Joy Wright | Specialist | 1014 Grand Boulevard Suite 5, Deer Park, NY 11729 | 2019-08-01 |
| 1568929131 | Corrine E. Hibbert | Case Manager/Care Coordinator | 140 Villa Avenue, Deer Park Ny, NY 11729 | 2019-03-01 |
| 1922525286 | Melissa Ramistella | Behavioral Analyst | 6 Angelica Street, Deer Park, NY 11729 | 2017-08-28 |
| 1609224153 | Corvitals, Inc. | Clinical Medical Laboratory | 590 Nichols Road, Suite 1, Deer Park, NY 11729 | 2016-05-25 |
| 1417375312 | Venel Maitre | Registered Nurse | 54 Duke St, Deer Park, NY 11729 | 2014-03-29 |
| 1578819157 | Koa K Robinson | Registered Nurse | 375 Carlls Place, 329, Deer Park, NY 11729 | 2012-08-01 |
| 1649532409 | Theresa L Lerro | Counselor | 1 Brandyine Drive, Deer Park, NY 11729 | 2012-06-07 |
| 1417218827 | Abilities Unlimited of N.y. | Durable Medical Equipment & Medical Supplies | 90 E. Jefryn Blvd., Deer Park, NY 11729 | 2012-06-01 |
| 1356600811 | Jennifer A. D'auria | Speech-Language Pathologist | 101 Lake Ave., Jfk Intermediate School, Deer Park, NY 11729 | 2012-05-03 |
| 1013280254 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 1900 The Arches Circle, Deer Park, NY 11729 | 2012-02-20 |
| Find all providers in zip 11729 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454481 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1900 The Arches Cir, Deer Park, NY 11729-7075 | 2020-10-13 |
| 1013280254 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 1900 The Arches Circle, Deer Park, NY 11729 | 2012-02-20 |
| 1275861882 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1431 The Arches Cir, Deer Park, NY 11729-7070 | 2009-11-20 |
| 1053709865 | Lacey Boggan | Eyewear Supplier (Equipment, not the service) | 9 N Main St, Deer Park, WA 99006 | 2014-12-31 |
| 1003086596 | Michelle Eva Lamb | Eyewear Supplier (Equipment, not the service) | 310 W San Augustine St, Deer Park, TX 77536-4028 | 2008-03-11 |
| 1194942938 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 20530 N Rand Rd, Deer Park Town Ctr Ste #432, Deer Park, IL 60010-7233 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202495 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 339 Gateway Dr, Brooklyn, NY 11239-2805 | 2020-10-16 |
| 1386242360 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 184 W 237th St, Bronx, NY 10463-4102 | 2020-10-13 |
| 1740888718 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 40 Graham Rd W, Ithaca, NY 14850-1055 | 2020-10-13 |
| 1619575578 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 900 Remsen Ave, Canarsie, NY 11236 | 2020-10-13 |
| 1831797828 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 790 S Sunrise Hwy, Bellport, NY 11713-1557 | 2020-10-13 |
| 1265030126 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 820-825 Pelham Pkwy, Pelham Manor, NY 10803 | 2020-10-13 |
| 1265030357 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 607 Old Country Rd, Riverhead, NY 11901-2103 | 2020-10-12 |
| 1356949598 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1752 Shore Pkwy, Brooklyn, NY 11214-6561 | 2020-10-10 |
| 1033717277 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 300 Bellwood Dr, Rochester, NY 14606-4262 | 2020-10-10 |
| 1871191015 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 3056 Sheridan Dr, Amherst, NY 14226-1901 | 2020-10-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.