Provider Demographics
NPI:1295179349
Name:RAJANN OPTICS INC.
Entity Type:Organization
Organization Name:RAJANN OPTICS INC.
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHENDRADAT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBIDAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-497-5470
Mailing Address - Street 1:5625 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-4740
Mailing Address - Country:US
Mailing Address - Phone:718-497-5470
Mailing Address - Fax:718-386-0532
Practice Address - Street 1:5625 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-4740
Practice Address - Country:US
Practice Address - Phone:718-497-5470
Practice Address - Fax:718-386-0532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty