Provider Demographics
NPI:1134778277
Name:RAY OF SUNSHINE OPTICAL,LLC
Entity type:Organization
Organization Name:RAY OF SUNSHINE OPTICAL,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OPTICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAJOIE-RAY
Authorized Official - Suffix:
Authorized Official - Credentials:LO 001608
Authorized Official - Phone:860-232-7616
Mailing Address - Street 1:1007 FARMINGTON AVE STE 16
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2107
Mailing Address - Country:US
Mailing Address - Phone:860-232-7616
Mailing Address - Fax:860-233-4565
Practice Address - Street 1:1007 FARMINGTON AVE STE 16
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2107
Practice Address - Country:US
Practice Address - Phone:860-232-7616
Practice Address - Fax:860-233-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service