Healthcare Provider Details

I. General information

NPI: 1467379271
Provider Name (Legal Business Name): CASSANDRA SANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 ATWELLS AVE
PROVIDENCE RI
02909-7403
US

IV. Provider business mailing address

37 SAGAMORE DR
SOUTH DARTMOUTH MA
02748-1224
US

V. Phone/Fax

Practice location:
  • Phone: 401-273-7100
  • Fax:
Mailing address:
  • Phone: 508-542-4291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: