Provider Demographics
NPI:1649312430
Name:RAI, RITU (OD)
Entity type:Individual
Prefix:DR
First Name:RITU
Middle Name:
Last Name:RAI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 RECTOR PL
Mailing Address - Street 2:APT 2P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10280-1441
Mailing Address - Country:US
Mailing Address - Phone:315-212-9003
Mailing Address - Fax:
Practice Address - Street 1:362 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1028
Practice Address - Country:US
Practice Address - Phone:718-643-0742
Practice Address - Fax:718-643-0744
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006693152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist