Provider Demographics
NPI:1932893468
Name:MOUNT VERNON EYECARE LLC
Entity type:Organization
Organization Name:MOUNT VERNON EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZZANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-263-4323
Mailing Address - Street 1:1558 COSHOCTON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-5416
Mailing Address - Country:US
Mailing Address - Phone:740-263-4323
Mailing Address - Fax:740-309-3320
Practice Address - Street 1:1558 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-5416
Practice Address - Country:US
Practice Address - Phone:740-263-4323
Practice Address - Fax:740-309-3320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty