Provider Demographics
NPI:1114775947
Name:COAST TO COAST VISION LLC
Entity type:Organization
Organization Name:COAST TO COAST VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIDINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-749-5069
Mailing Address - Street 1:38639 ADKINS RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7512
Mailing Address - Country:US
Mailing Address - Phone:440-749-5069
Mailing Address - Fax:
Practice Address - Street 1:6380 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2548
Practice Address - Country:US
Practice Address - Phone:440-428-2172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty