Individual
DR. LEE J RAYKOVICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
724 ARDEN LN, SUITE 120, ROCK HILL, SC 29732-2996
(704) 334-2020
(704) 334-6175
Mailing address
2015 RANDOLPH RD, SUITE 108, CHARLOTTE, NC 28207-1128
(704) 334-2020
(704) 334-6175
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1872
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093M5
BCBS NC
NC
01
—
2200418
UNITEDHEALTCARE
NC
05
—
89093M5
—
NC
01
—
AA43231092
MEDICARE
SC
05
—
DN1872
—
NC
Enumeration date
12/13/2005
Last updated
01/03/2013
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