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General NPI Number Information
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NPI Number | 1417715236
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Entity Type | Individual
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Provider Name | AVA J. WALSH OD
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Gender | Female
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 280 SCHOOL ST STE J140
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City | MANSFIELD
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State | MA
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Zip | 02048-1845
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Country | US
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Telephone | 508-594-4510
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Fax | 508-594-4520
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Provider Business Mailing Address
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Address Line | 375 ALLENS AVE
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City | PROVIDENCE
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State | RI
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Zip | 02905-5010
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Country | US
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Telephone | 401-444-0400
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Fax |
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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 | OPT5704
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODTG00757
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License Number State | RI
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