1184068322 NPI number — RAYMOND OPTICIANS

Table of content: (NPI 1184068322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184068322 NPI number — RAYMOND OPTICIANS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAYMOND OPTICIANS
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:
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:
1184068322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
827 ROUTE 82
Provider Second Line Business Mailing Address:
UNITY PLAZA UNIT #7
Provider Business Mailing Address City Name:
HOPEWELL JUNCTION
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12533-7351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-223-2010
Provider Business Mailing Address Fax Number:
845-227-8003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
827 ROUTE 82
Provider Second Line Business Practice Location Address:
UNITY PLAZA UNIT #7
Provider Business Practice Location Address City Name:
HOPEWELL JUNCTION
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12533-7351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-223-2010
Provider Business Practice Location Address Fax Number:
845-227-8003
Provider Enumeration Date:
04/18/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KOLKMANN
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
914-245-5151

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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