Healthcare Provider Details

I. General information

NPI: 1770879298
Provider Name (Legal Business Name): NERMIN GRAISE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NERMIN GIRGIS

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 TOLL GATE RD
WARWICK RI
02886-2716
US

IV. Provider business mailing address

566 TOLL GATE RD
WARWICK RI
02886-2716
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-4800
  • Fax: 401-738-8153
Mailing address:
  • Phone: 401-738-4800
  • Fax: 401-738-8153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD15522
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: