Provider Demographics
NPI:1285859827
Name:R AND R OPTICAL, INC.
Entity Type:Organization
Organization Name:R AND R OPTICAL, INC.
Other - Org Name:COHEN'S FASHION OPTICAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-795-3030
Mailing Address - Street 1:5284 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-2907
Mailing Address - Country:US
Mailing Address - Phone:516-795-3030
Mailing Address - Fax:516-795-2418
Practice Address - Street 1:5284 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2907
Practice Address - Country:US
Practice Address - Phone:516-795-3030
Practice Address - Fax:516-795-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003430-0152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWYRRP1Medicare PIN
NY6199130001Medicare NSC