Organization
RAINES OPTICAL COMPANY, LLC
Active
Other names
WAVECREST OPTICAL SHOP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY S RAINES OPTICIAN (OPH DISP) (CHIEF OPERATING OFFICER)
(718) 327-2020
Entity
Organization
Contact information
Practice address
257 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3625
(718) 327-2020
(718) 327-3429
Mailing address
257 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3625
(718) 327-2020
(718) 327-3429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV-004963-1
NY
332H00000X
Eyewear Supplier
5665
NY
Other
Enumeration date
03/15/2007
Last updated
04/22/2008
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