Healthcare Provider Details

I. General information

NPI: 1477618841
Provider Name (Legal Business Name): JOSEPH V GIRGENTI OD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 VILLAGE PLAZA WAY BOX 4
N SCITUATE RI
02857-1849
US

IV. Provider business mailing address

17 VILLAGE PLAZA WAY
N SCITUATE RI
02857-1849
US

V. Phone/Fax

Practice location:
  • Phone: 401-934-2800
  • Fax:
Mailing address:
  • Phone: 401-934-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTA00432
License Number StateRI

VIII. Authorized Official

Name: DR. JOSEPH VICTOR GIRGENTI
Title or Position: PRESIDENT
Credential: O.D.
Phone: 401-934-2800