Provider Demographics
NPI:1477842383
Name:ROCHDALE VISION CENTER INC.
Entity Type:Organization
Organization Name:ROCHDALE VISION CENTER INC.
Other - Org Name:STERLING OPTICAL #415
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-276-0055
Mailing Address - Street 1:16520 BAISLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2517
Mailing Address - Country:US
Mailing Address - Phone:718-276-0055
Mailing Address - Fax:718-276-5059
Practice Address - Street 1:16520 BAISLEY BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2517
Practice Address - Country:US
Practice Address - Phone:718-276-0055
Practice Address - Fax:718-276-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG100050476Medicare PIN