Healthcare Provider Details

I. General information

NPI: 1336405422
Provider Name (Legal Business Name): VISION ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 SOCIAL ST
WOONSOCKET RI
02895-3133
US

IV. Provider business mailing address

148 SOCIAL ST
WOONSOCKET RI
02895-3133
US

V. Phone/Fax

Practice location:
  • Phone: 401-769-2755
  • Fax: 401-229-6386
Mailing address:
  • Phone: 401-769-2755
  • Fax: 401-229-6386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTA00340
License Number StateRI

VIII. Authorized Official

Name: MR. JOHN JOSEPH BREENE
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 401-229-6386