Provider Demographics
NPI:1013890425
Name:VISTA VISION LLC
Entity type:Organization
Organization Name:VISTA VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAITHATHA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-674-3336
Mailing Address - Street 1:86 STANTON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1441
Mailing Address - Country:US
Mailing Address - Phone:201-674-3336
Mailing Address - Fax:
Practice Address - Street 1:100 14TH ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1202
Practice Address - Country:US
Practice Address - Phone:201-674-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty