Provider Demographics
NPI:1497896872
Name:THE VILLAGE OPTICIAN
Entity Type:Organization
Organization Name:THE VILLAGE OPTICIAN
Other - Org Name:RAYMOND OPTICIANS OF NEW ROCHELLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-245-5151
Mailing Address - Street 1:521 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6334
Mailing Address - Country:US
Mailing Address - Phone:914-245-5151
Mailing Address - Fax:
Practice Address - Street 1:521 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6334
Practice Address - Country:US
Practice Address - Phone:914-245-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty