| NPI | 1780765354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWINA L REGO Manager 401-274-5844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-07-21 |