Healthcare Provider Details

I. General information

NPI: 1386222370
Provider Name (Legal Business Name): AMANDA G. PAREDES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 MENDON RD
WOONSOCKET RI
02895-2477
US

IV. Provider business mailing address

7 FAIRMOUNT AVE
HYDE PARK MA
02136-2701
US

V. Phone/Fax

Practice location:
  • Phone: 401-762-4473
  • Fax: 401-765-3261
Mailing address:
  • Phone: 617-361-0618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberMA5484
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODTG00716
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: