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General NPI Number Information
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NPI Number | 1407853997
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Entity Type | Individual
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Provider Name | PAMELA J BLODGETT O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1120 TOLLGATE ROAD SUITE C
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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 | 401-822-2020
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Fax | 401-823-5852
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Provider Business Mailing Address
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Address Line | 1120 TOLL GATE RD SUITE C
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City | WARWICK
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State | RI
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Zip | 02886-0648
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Country | US
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Telephone | 401-822-2020
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Fax | 401-823-5852
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | ODTA00417
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License Number State | RI
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