Healthcare Provider Details

I. General information

NPI: 1225653173
Provider Name (Legal Business Name): BRYANNA MORGAN CARON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 POUND HILL RD STE 104
NORTH SMITHFIELD RI
02896-9358
US

IV. Provider business mailing address

56 WHIPPLE RD
SMITHFIELD RI
02917-2513
US

V. Phone/Fax

Practice location:
  • Phone: 401-769-6323
  • Fax:
Mailing address:
  • Phone: 401-744-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTG00695
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT8363
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: