Healthcare Provider Details

I. General information

NPI: 1093966954
Provider Name (Legal Business Name): NORA ANN M GRILLS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORA ANN M LUCCHI O.D.

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WELLS ST STE 101
WESTERLY RI
02891-2923
US

IV. Provider business mailing address

17 WELLS ST STE 101
WESTERLY RI
02891-2923
US

V. Phone/Fax

Practice location:
  • Phone: 401-348-2020
  • Fax:
Mailing address:
  • Phone: 401-348-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2750
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTG00764
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: