Wavecrest Optical Shop

LBN: Wavecrest Optical Shop
Wavecrest Optical Shop is an health care organization with primary practice located at 257 Beach 20Th St , Far Rockaway NY 11691-3625. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Wavecrest Optical Shop can be contacted via phone (718) 327-2020, or through Raines, Barry via phone (718) 327-2020.

Contact Information

Primary practice address
257 Beach 20Th St Far Rockaway NY 11691-3625
Phone: (718) 327-2020
Fax: (718) 327-3429
Website:
Map and Directions
Authorized official contact:
Name: Raines, Barry
Phone: (718) 327-2020

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 005665 New York

Profile Details

NPI number 1407057136
LBN Legal business name Wavecrest Optical Shop
DBA Doing business as
Authorized official Raines, Barry
Entity Organization
Organization subpart 1 No
Enumeration date May 30th, 2007
Last updated Aug 16th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407057136 NPPES
New York MEDICAID 01136483

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