Healthcare Provider Details

I. General information

NPI: 1881002038
Provider Name (Legal Business Name): TOLL GATE VISION, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 TOLL GATE RD
WARWICK RI
02886-0648
US

IV. Provider business mailing address

1120 TOLL GATE RD
WARWICK RI
02886-0648
US

V. Phone/Fax

Practice location:
  • Phone: 401-821-9111
  • Fax: 401-823-5852
Mailing address:
  • Phone: 401-821-9111
  • Fax: 401-823-5852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD P BELHUMEUR
Title or Position: PRESIDENT
Credential: OD
Phone: 401-822-2020