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Organization

KOCH EYE ASSOCIATES

Active
Parent organization
CLARIS VISION HOLDINGS LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CLARIS VISION HOLDINGS LLC
Authorized official
MARCELLO CELENTANO (CEO)
(774) 320-3040
Entity
Organization

Contact information

Practice address
42 VALLEY RD, MIDDLETOWN, RI 02842-6400
(401) 849-4645
Mailing address
175 PARAMOUNT DR, SUITE 203, RAYNHAM, MA 02767-1065
(774) 320-3040
(508) 910-2204

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
156FX1800X
Optician
207W00000X
Ophthalmology Physician
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CC8793
RAILROAD MEDICARE
Enumeration date
10/11/2016
Last updated
07/10/2023
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