Provider Demographics
NPI:1467887893
Name:RATHJENS VISION CARE, PC
Entity Type:Organization
Organization Name:RATHJENS VISION CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RATHJENS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-878-6574
Mailing Address - Street 1:1201 BOSTON POST RD STE 2063
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-9014
Mailing Address - Country:US
Mailing Address - Phone:203-878-6574
Mailing Address - Fax:203-878-0881
Practice Address - Street 1:1201 BOSTON POST RD STE 2063
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-9014
Practice Address - Country:US
Practice Address - Phone:203-878-6574
Practice Address - Fax:203-878-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty