Provider Demographics
NPI:1154465623
Name:RYCAM LLC
Entity Type:Organization
Organization Name:RYCAM LLC
Other - Org Name:VISION DECISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAFICANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-255-2020
Mailing Address - Street 1:40 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2037
Mailing Address - Country:US
Mailing Address - Phone:516-255-2020
Mailing Address - Fax:516-255-1818
Practice Address - Street 1:40 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2037
Practice Address - Country:US
Practice Address - Phone:516-255-2020
Practice Address - Fax:516-255-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005759152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherEMPLOYER IDENTIFICATION #