Provider Demographics
NPI:1063645653
Name:RAINES OPTICAL COMPANY LLC
Entity Type:Organization
Organization Name:RAINES OPTICAL COMPANY LLC
Other - Org Name:THE PERFECT SPECTACLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAINES
Authorized Official - Suffix:
Authorized Official - Credentials:OPHTHALMIC DISPENSER
Authorized Official - Phone:516-869-5998
Mailing Address - Street 1:572 PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1946
Mailing Address - Country:US
Mailing Address - Phone:516-869-5998
Mailing Address - Fax:516-869-3513
Practice Address - Street 1:572 PLANDOME RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1946
Practice Address - Country:US
Practice Address - Phone:516-869-5998
Practice Address - Fax:516-869-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5665156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty