Provider Demographics
NPI:1912143926
Name:JAMES P RAYMONDI, OD, INC
Entity Type:Organization
Organization Name:JAMES P RAYMONDI, OD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAYMONDI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-966-8201
Mailing Address - Street 1:1981 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-3333
Mailing Address - Country:US
Mailing Address - Phone:330-966-8201
Mailing Address - Fax:
Practice Address - Street 1:1981 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-3333
Practice Address - Country:US
Practice Address - Phone:330-966-8201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3960152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRA0669085Medicaid
0662613Medicare PIN
T91561Medicare UPIN
9380151Medicare PIN