Provider Demographics
NPI:1740581321
Name:VISION WORLD PROF CORP
Entity Type:Organization
Organization Name:VISION WORLD PROF CORP
Other - Org Name:VISION WORLD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAITHATHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-629-2134
Mailing Address - Street 1:206 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2304
Mailing Address - Country:US
Mailing Address - Phone:908-629-2134
Mailing Address - Fax:908-629-2136
Practice Address - Street 1:206 BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2304
Practice Address - Country:US
Practice Address - Phone:908-629-2134
Practice Address - Fax:908-629-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty