1932285939 NPI number — LAXMI AMERICAN OPTICAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932285939 NPI number — LAXMI AMERICAN OPTICAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAXMI AMERICAN OPTICAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932285939
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
83 16 NOTHERN BLVD
Provider Second Line Business Mailing Address:
LAXMI AMERICAN OPTICL
Provider Business Mailing Address City Name:
JACKSON HEIGHTS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-335-2240
Provider Business Mailing Address Fax Number:
718-335-2241

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
83 16 NOTHERN BLVD
Provider Second Line Business Practice Location Address:
LAXMI AMERICAN OPTICAL
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-335-2240
Provider Business Practice Location Address Fax Number:
718-335-2241
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUMAR
Authorized Official First Name:
VIKAS
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTICIAN
Authorized Official Telephone Number:
718-335-2240

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  007786 1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02744076 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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