Healthcare Provider Details

I. General information

NPI: 1770761660
Provider Name (Legal Business Name): GIULIO G DIAMANTE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 HARTFORD AVE
JOHNSTON RI
02919-7121
US

IV. Provider business mailing address

1277 HARTFORD AVE
JOHNSTON RI
02919-7121
US

V. Phone/Fax

Practice location:
  • Phone: 401-521-3606
  • Fax: 401-453-3288
Mailing address:
  • Phone: 401-521-3606
  • Fax: 401-453-3288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GIULIO GERARDO DIAMANTE
Title or Position: OWNER, PRESIDENT
Credential: MD
Phone: 401-521-3606