Organization
BARRY SCOTT RAINES
Active
Organization
BARRY SCOTT RAINES
Active
Other names
Wavecrest Optical Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY SCOTT RAINES OPHTHALMIC DISPENSER (OPTICIAN/OWNER)
(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
332H00000X
Eyewear Supplier
Primary
005665
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01136483
—
NY
Enumeration date
12/14/2005
Last updated
07/20/2007
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