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General NPI Number Information
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NPI Number | 1316581424
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Entity Type | Organization
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Legal Business Name | DR. DEGIULIO & ASSOCIATES INC
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 400 BALD HILL ROAD STE 163 WARWICK MALL
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City | WARWICK
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State | RI
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Zip | 02886
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Country | US
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Telephone | 401-738-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 13 CAPRI DR
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City | JOHNSTON
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State | RI
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Zip | 02919-3328
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Country | US
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Telephone | 401-474-4963
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA DEGIULIO
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Credential | OD
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Telephone | 401-474-4963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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