Healthcare Provider Details

I. General information

NPI: 1265938179
Provider Name (Legal Business Name): MODERN EYES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1970 PAWTUCKET AVE
EAST PROVIDENCE RI
02914-1718
US

IV. Provider business mailing address

1970 PAWTUCKET AVE
EAST PROVIDENCE RI
02914-1718
US

V. Phone/Fax

Practice location:
  • Phone: 401-438-1166
  • Fax: 401-438-1614
Mailing address:
  • Phone: 401-438-1166
  • Fax: 401-438-1614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTG00620
License Number StateRI

VIII. Authorized Official

Name: VINCENZO L GIANFRANCESCO
Title or Position: OPTOMETRIST
Credential: OD
Phone: 401-438-1166