Provider Demographics
NPI:1912064023
Name:RJ BUSCH OPTICAL DESIGNS, INC.
Entity type:Organization
Organization Name:RJ BUSCH OPTICAL DESIGNS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-393-3360
Mailing Address - Street 1:915 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6116
Mailing Address - Country:US
Mailing Address - Phone:518-393-3360
Mailing Address - Fax:518-393-1699
Practice Address - Street 1:915 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6116
Practice Address - Country:US
Practice Address - Phone:518-393-3360
Practice Address - Fax:518-393-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC0045271332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1028190001Medicare NSC