Healthcare Provider Details

I. General information

NPI: 1720130545
Provider Name (Legal Business Name): IN-SIGHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 JEFFERSON BLVD
WARWICK RI
02888-1078
US

IV. Provider business mailing address

43 JEFFERSON BLVD SUITE 1
WARWICK RI
02888-1078
US

V. Phone/Fax

Practice location:
  • Phone: 401-941-3322
  • Fax:
Mailing address:
  • Phone: 401-941-3322
  • Fax: 401-941-3356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER BUTLER
Title or Position: EXEC DIRECTOR
Credential:
Phone: 401-941-3322