Healthcare Provider Details

I. General information

NPI: 1023399318
Provider Name (Legal Business Name): CANDESCENT EYE SURGICENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 QUAKER LN
WARWICK RI
02886-0185
US

IV. Provider business mailing address

51 STATE RD
DARTMOUTH MA
02747-3319
US

V. Phone/Fax

Practice location:
  • Phone: 401-384-6537
  • Fax:
Mailing address:
  • Phone: 774-320-3040
  • Fax: 508-910-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberPENDING
License Number StateRI

VIII. Authorized Official

Name: COREY B WESTERFELD
Title or Position: MD
Credential: MD
Phone: 508-910-2204