PORT JEFFERSON OPTICIANS INC NPI 1154443158

NPI Information

NPI: 1154443158
Provider Name: PORT JEFFERSON OPTICIANS INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Doing Business As: BROOKHAVEN OPTICIANS
Address: 208 ROUTE 112 STE 2
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 331-0600

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NPI Details

PORT JEFFERSON OPTICIANS INC is a durable medical equipment medical supplies in Port Jefferson Station, NY. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. PORT JEFFERSON OPTICIANS INC NPI is 1154443158. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookhaven Opticians.

The provider's business location address is:

208 ROUTE 112 STE 2
PORT JEFFERSON STATION, NY
ZIP 11776-013
Phone: (631) 331-0600
Fax: (631) 331-0809

The provider's authorized official is Paul Mastrorocco .
The authorized official title is President/optician and has the following contact phone number (631) 331-0600.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 9/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01934578	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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